Clinical, Laboratory, Histopathological and Therapeutic Profile of Livedoid Vasculopathy: A Case Series of 17 Patients

Livedoid vasculopathy is a rare disorder clinically presenting with triad of livedo reticularis, leg ulcerations, and atrophie blanche. We present a case series of 17 patients with clinical and/or histopathologically confirmed livedoid vasculopathy from a single tertiary centre in India with female-to-male ratio of 1.5:1 and mean age of 36.12 ± 12.02 years. Presentation with burning pain around ankles was seen in 83.33% of patients, while 100% had atrophie blanche/scarring and 76.47% had retiform ulcers. Hypercholesterolemia was seen in four patients, while systemic lupus erythematosus (SLE), anti-phospholipid antibody with SLE, dermatomyositis and hyper-homocysteinemia were seen in one patient each. The most common histopathology finding was hyaline thrombi within dermal vessels in 94.11%. On treatment with dual anti-platelet therapy, 70.58% of patients could achieve significant improvement in their Visual Analog Scale, Dermatology Life Quality Index and reduction in ulcer scores without serious adverse events. Out of 17 patients, 11 experienced flare in their disease course over one year period of follow-up. This cohort aims to contribute to Indian literature of this underreported entity.