Characteristics, risk factors and treatment reality in livedoid vasculopathy – a multicentre analysis

C. Weishaupt, A. Strölin, B. Kahle, A. Kreuter, S. W. Schneider, J. Gerss, M. Eveslage, A. Drabik, T. Goerge*

*Corresponding author for this work
9 Citations (Scopus)


Background: Livedoid vasculopathy (LV) is a rare cutaneous thrombotic disease. It is characterized by occlusion of dermal vessels resulting in livedo racemosa, ulceration and atrophie blanche. Clear guidelines for diagnosis and treatment are missing. Objective: The purpose of this study was to better characterize epidemiology, clinical appearance and treatment reality of LV in a well-defined patient cohort. Methods: The cohort was allocated within a prospective, multicentre, phase IIa trial that investigated the effect of rivaroxaban in LV. Results: Analysis of 27 patients revealed that LV patients had an increased Body Mass Index (BMI; 11/27), hypertension (19/27) and increased levels of lipoprotein (a) (5/12) and homocysteine (10/12) in the blood. The female-to-male ratio was 2.1 : 1, and the median age was 53.0 years [interquartile range (IQR) 40.5–68]. Investigation of the clinical appearance found that 82% of patients had livedo racemosa, and the ankle region was most likely to be affected by ulceration (56–70%). The analysis of patient treatment history showed that heparin was most effective (12/17), while anti-inflammatory regimens were, although often used (17/24), not effective (0/17). Conclusion: We add clinical clues for a data supported diagnosis of LV, and we provide evidence that anticoagulants should be administered in monotherapy first line (EudraCT number 2012-000108-13-DE).

Original languageEnglish
JournalJournal of the European Academy of Dermatology and Venereology
Issue number9
Pages (from-to)1784-1791
Number of pages8
Publication statusPublished - 01.09.2019


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