Livedoid vasculitis - Vasculitis Livedoid
Vasculitis Livedoid (Livedoid vasculitis) ialah penyakit kulit kronik yang kebanyakannya ditemui pada wanita muda hingga pertengahan usia. Akronim yang digunakan untuk menggambarkan ciri‑ciri penyakit ini ialah “ulser purpura yang menyakitkan dengan corak retikular pada bahagian bawah kaki” (UNGGU). Penyakit ini dikaitkan dengan beberapa keadaan, termasuk hipertensi vena kronik dan varikos.
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ReferencesLivedoid vasculopathy adalah keadaan kulit yang jarang berlaku, dicirikan oleh ulser menyakitkan yang berulang pada bahagian bawah kaki.
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 ialah keadaan kulit yang jarang berlaku, yang menyebabkan ulser berulang pada bahagian bawah kaki dan meninggalkan parut pucat yang dikenali sebagai atrophie blanche. Walaupun punca sebenar masih tidak jelas, dipercayai bahawa peningkatan pembekuan darah (hypercoagulability) adalah faktor utama, dengan keradangan memainkan peranan kedua. Faktor‑faktor yang menyumbang kepada pembekuan termasuk: deficiencies in proteins C and S, mutasi genetik seperti factor V Leiden, antithrombin III deficiency, prothrombin gene mutations, dan paras homocysteine yang tinggi. Dalam biopsi, didapati terdapat pembekuan darah dalam saluran, penebalan dinding saluran, serta pembentukan parut. Rawatan melibatkan pendekatan pelbagai serampang yang memfokuskan pada pencegahan pembekuan darah dengan ubat‑ubatan seperti anti‑platelet, agen antikoagulan, dan terapi fibrinolitik. Pelbagai ubat boleh digunakan untuk keadaan kulit ini, termasuk colchicine dan hydroxychloroquine, vasodilator, serta immunosuppressant.
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 adalah keadaan yang jarang berlaku, di mana lesi muncul pada kedua‑dua kaki. Pembentukan bekuan darah dalam saluran darah kecil dipercayai disebabkan oleh peningkatan koagulasi serta pengurangan fibrinolisis, bersama-sama dengan kerosakan pada lapisan endotel. Keadaan ini lebih kerap dijumpai pada wanita, terutamanya berumur antara 15 hingga 50 tahun. Menghentikan merokok, menjaga kebersihan luka, dan menggunakan ubat seperti anticoagulant (ubat pencair darah) serta antiplatelet (ubat antiplatelet) telah terbukti berkesan.
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.
