Livedoid vasculitis - リベド血管炎
リベド血管炎 (Livedoid vasculitis) は、主に若年から中年の女性にみられる慢性皮膚疾患です。その特徴を表す頭字語の一つに「下肢の網状パターンを伴う痛みを伴う紫斑性潰瘍」(PURPLE) があります。慢性静脈高血圧症や静脈瘤など、さまざまな疾患と関連しています。
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ドイツの2022年Stiftung Warentestの結果では、ModelDermに対する消費者満足度は有料の遠隔医療相談よりもわずかに低いだけでした。
ドイツの2022年Stiftung Warentestの結果では、ModelDermに対する消費者満足度は有料の遠隔医療相談よりもわずかに低いだけでした。
痛みを伴うこともあります。
relevance score : -100.0%
ReferencesLivedoid vasculopathy は、下肢に再発を繰り返し、痛みを伴う潰瘍が特徴のまれな皮膚疾患です。
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 は、下肢に再発性の潰瘍を生じ、白萎縮（淡い傷跡）として知られる痕跡を残すまれな皮膚疾患です。原因はまだ不明ですが、血液凝固の亢進 (hypercoagulability) が主な要因と考えられ、炎症は二次的な役割を果たすとされています。凝固に関与する因子としては、タンパク質C・S の欠乏、factor V Leiden などの遺伝子変異、抗トロンビンIII 欠乏、プロトロンビン遺伝子変異、ホモシステイン高値などが挙げられます。生検では血管内に血栓が認められ、血管壁の肥厚や瘢痕化がみられます。治療は、抗血小板薬・抗凝血薬・線溶療法などを組み合わせ、血栓形成の予防に重点を置く多角的アプローチが必要です。使用される薬剤には colchicine、hydroxychloroquine、vasodilators、immunosuppressants などがあります。
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は、両脚に病変が生じる稀な疾患です。小さな血管内で血栓が形成されるのは、血管内皮の損傷に加えて、凝固が亢進し、血栓溶解が低下することが原因と考えられています。女性、特に15〜50歳の方に多く見られます。禁煙や創傷の適切な管理、抗凝固薬や抗血小板薬などの投薬が有効です。
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.
