Livedoid vasculitis - Vasculite Livedoïde
La Vasculite Livedoïde (Livedoid vasculitis) est une maladie cutanée chronique, observée principalement chez les femmes jeunes ou d’âge moyen. Un acronyme utilisé pour décrire ses caractéristiques est « Ulcères purpuriques douloureux avec motif réticulaire des membres inférieurs » (VIOLET). Elle est associée à plusieurs affections, notamment l’hypertension veineuse chronique et les varicosités.
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ReferencesLivedoid vasculopathy est une affection cutanée rare, caractérisée par des ulcères douloureux récurrents au niveau du bas des jambes.
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 est une affection cutanée rare qui provoque des ulcères récurrents sur le bas des jambes, laissant derrière eux des cicatrices pâles appelées atrophie blanche. Bien que la cause exacte ne soit pas encore claire, on pense que l’augmentation de la coagulation sanguine (hypercoagulability) est le principal facteur, l’inflammation jouant un rôle secondaire. Les facteurs contribuant à la coagulation sont les suivants : deficiencies in proteins C and S, genetic mutations like factor V Leiden, antithrombin III deficiency, prothrombin gene mutations, high levels of homocysteine. Dans les biopsies, la maladie montre des caillots sanguins à l’intérieur des vaisseaux, un épaississement des parois vasculaires et des cicatrices. Le traitement implique une approche à plusieurs volets axée sur la prévention des caillots sanguins avec des médicaments tels que des antiplaquettaires, des anticoagulants et un traitement fibrinolytique. Divers médicaments peuvent être utilisés pour cette affection cutanée – colchicine et hydroxychloroquine, des vasodilatateurs, des immunosuppresseurs.
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 est une maladie rare dans laquelle des lésions apparaissent sur les deux jambes. On pense que la formation de caillots sanguins dans de minuscules vaisseaux est due à une augmentation de la coagulation, à une réduction de la dégradation des caillots et à des lésions de la paroi vasculaire. C'est plus fréquent chez les femmes, surtout entre 15 et 50 ans. Arrêter de fumer, soigner les plaies et utiliser des médicaments tels que les anticoagulants et les antiplaquettaires se sont avérés efficaces.
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.
