Livedoid vasculitis
Livedoid vasculitis በአብዛኛው ከወጣት እስከ መካከለኛ ዕድሜ ላይ ባሉ ሴቶች ላይ የሚታይ ሥር የሰደደ የቆዳ በሽታ ነው። ባህሪያቱን ለመግለጽ አንድ ምህጻረ ቃል “የታችኛው ዳርቻዎች ሬቲኩላር ቅርፅ ያላቸው የሚያም የፐርፕዩሪክ ቁስሎች” (PurpLE) ነው። ሥር የሰደደ የደም ግፊት እና የ varicosities ጨምሮ ከበርካታ በሽታዎች ጋር የተያያዘ ነው.
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ReferencesLivedoid vasculopathy በጣም አልፎ አልፎ የሚከሰት የቆዳ ህመም ሲሆን፣ ህመሙ የሚያስከትሉ ቁስሎች በታች እግሮች ላይ በተደጋጋሚ ይታያሉ።
Livedoid vasculopathy (LV) is a rare thrombotic vasculopathy of the dermis characterized by painful, relapsing ulcers over the lower extremities. Diagnosis is challenging due to the overlap in clinical appearance and nomenclature with other skin disorders. Treatment selection is complicated by poor understanding of the pathogenesis of LV and lack of robust clinical trials evaluating therapy efficacy. The terminology and pathophysiology of LV are reviewed here, along with its epidemiology, clinical and histologic features, and treatment options. A diagnostic pathway is suggested to guide providers in evaluating for comorbidities, referring to appropriate specialists, and choosing from the available classes of therapy.
Livedoid vasculopathy (LV) is a rare thrombotic vasculopathy of the dermis characterized by painful, relapsing ulcers over the lower extremities. Diagnosis is challenging due to the overlap in clinical appearance and nomenclature with other skin disorders. Treatment selection is complicated by poor understanding of the pathogenesis of LV and lack of robust clinical trials evaluating therapy efficacy. The terminology and pathophysiology of LV are reviewed here, along with its epidemiology, clinical and histologic features, and treatment options. A diagnostic pathway is suggested to guide providers in evaluating for comorbidities, referring to appropriate specialists, and choosing from the available classes of therapy.
Livedoid vasculopathy በግርጌ እግር ላይ ተደጋጋሚ ቁስለት የሚያመጣ የቆዳ በሽታ ነው። ይህ በአትሮፊ ብላንሽ (atrophic blanch) ተብሎ የሚታወቅ ገርጣ ጠባሳዎችን ያስቀራል። ትክክለኛው ምክንያት እስካሁን ግልጽ አይደለም፣ ነገርግን የደም መርጋት (hypercoagulability) የተጨማሪ ዋነኛ ምክንያት እንደሆነ ይታሰባል። የሁለተኛ ደረጃ አስተዋጽኦ ደግሞ ሊኖረው ይችላል። የደም መርጋትን የሚያስነሳ አደገኞች እነዚህን ያካትታሉ፡‑ የፕሮቲን C እና S እጥረት (deficiencies in proteins C and S), factor V Leiden ያለው የጄኔቲክ ሙተሽን (genetic mutation), antithrombin III እጥረት, prothrombin gene ሙተሽን, እና ከፍተኛ የሆሞሲስቲን (homocysteine) ደረጃዎች። ባዮፕሲ (biopsy) ውስጥ የደም መርጋት ምልክቶች፣ የሚሰሩ ግድግዳዎች እና ጠባሳ ይታያሉ። ሕክምና በፀረ‑ፕሌትሌት መድሃኒቶች (anti‑platelet drugs), ደም ሰጪዎች (anticoagulants) እና ፋይብሪኖሊቲክ ሕክምና (fibrinolytic therapy) በመጠቀም የደም መርጋትን ለመከላከል ይሞክራሉ። ተጨማሪ የቆዳ ህመምን ለማስተካከል colchicine እና hydroxychloroquine, vasodilators, immunosuppressants ያሉትን መድሃኒቶች ሊውሉ ይችላል።
Livedoid vasculopathy is a rare skin condition that causes recurring ulcers on the lower legs, leaving behind pale scars known as atrophie blanche. While the exact cause is still unclear, it's believed that increased blood clotting (hypercoagulability) is the main factor, with inflammation playing a secondary role. Factors contributing to clotting include as follows - deficiencies in proteins C and S, genetic mutations like factor V Leiden, antithrombin III deficiency, prothrombin gene mutations, high levels of homocysteine. In biopsies, the condition shows blood clots inside vessels, thickening of vessel walls, and scarring. Treatment involves a multi-pronged approach focusing on preventing blood clots with medications like anti-platelet drugs, blood thinners, and fibrinolytic therapy. Various drugs can be used for this skin condition - colchicine and hydroxychloroquine, vasodilators, immunosuppressants.
Livedoid vasculopathy is a rare skin condition that causes recurring ulcers on the lower legs, leaving behind pale scars known as atrophie blanche. While the exact cause is still unclear, it's believed that increased blood clotting (hypercoagulability) is the main factor, with inflammation playing a secondary role. Factors contributing to clotting include as follows - deficiencies in proteins C and S, genetic mutations like factor V Leiden, antithrombin III deficiency, prothrombin gene mutations, high levels of homocysteine. In biopsies, the condition shows blood clots inside vessels, thickening of vessel walls, and scarring. Treatment involves a multi-pronged approach focusing on preventing blood clots with medications like anti-platelet drugs, blood thinners, and fibrinolytic therapy. Various drugs can be used for this skin condition - colchicine and hydroxychloroquine, vasodilators, immunosuppressants.
Livedoid vasculopathy በሁለቱም እግሮች ላይ ቁስሎች የሚከሰት ያልተለመደ ሁኔታ ነው። ይህ በጥቃቅን የደም ስሮች ውስጥ የደም መርጋትን ማፍሰስ፣ የመርጋት መጨምርና የመርጋት ስብራትን በመቀነስ እና በሽፋን ላይ የሚፈጥረውን ጉዳት ተያይዞ ተመስርቷል። በሴቶች ውስጥ በተለይ ከ15 እስከ 50 ዓመት ዕድሜ ውስጥ ተደጋጋሚ ይታያል። ማጨስን ማቆም፣ ቁስሎችን መንከባከብ፣ እና የደም ማነቃቂያ እና አንቲፕሌትሌት ያሉ መድሃኒቶችን መጠቀም ውጤታማ ነው።
Livedoid vasculopathy is a rare vasculopathy that is typically characterized by bilateral lower limb lesions. Increased thrombotic activity and decreased fibrinolytic activity along with endothelial damage are believed to be the cause of thrombus formation in the capillary vasculature. It is 3 times more common in females than in males, especially in patients between the ages of 15 to 50 years. There is no definite first-line treatment, but general measures like smoking cessation, wound care, and pharmacological measures like anticoagulants and antiplatelets have shown good results.
Livedoid vasculopathy is a rare vasculopathy that is typically characterized by bilateral lower limb lesions. Increased thrombotic activity and decreased fibrinolytic activity along with endothelial damage are believed to be the cause of thrombus formation in the capillary vasculature. It is 3 times more common in females than in males, especially in patients between the ages of 15 to 50 years. There is no definite first-line treatment, but general measures like smoking cessation, wound care, and pharmacological measures like anticoagulants and antiplatelets have shown good results.
