Livedoid vasculopathy: An in-depth analysis using a modified Delphi approach

详细信息    查看全文

• 作者：Afsaneh Alavi ; J眉rg Hafner ; Jan P. Dutz ; Dieter Mayer ; R. Gary Sibbald ; Paulo Ricardo Criado ; Patricia Senet ; Jeffery P. Callen ; Tania J. Phillips ; Marco Romanelli ; Robert S. Kirsner
• 关键词：atrophie ; blanche ; coagulopathy ; livedoid ; lower extremity ; vasculopathy
• 刊名：Journal of the American Academy of Dermatology
• 出版年：December, 2013
• 年：2013
• 卷：69
• 期：6
• 页码：1033-1042.e1
• 全文大小：928 K

文摘

Livedoid vasculopathy (LV) is a noninflammatory thrombotic condition presenting in a primary idiopathic or secondary subtype associated with abnormal coagulation factors. Different from atrophie blanche (AB), which is a clinical manifestation of certain scars, LV may have AB in combination with recurrent livedo reticularis with chronic and painful skin ulcers particularly around the ankle region, and at the back of the feet. Histology is characterized by segmental hyalinizing changes at the subintimal region of small dermal vessels with thrombotic occlusions. LV skin ulcers resolve with stellate, porcelain-white scars that need to be distinguished from similar changes seen with venous insufficiency. 鈥淎trophie blanche鈥?was originally used synonymously with 鈥渓ivedoid vasculopathy.鈥?AB describes spontaneously occurring porcelain-white skin areas with red dots that typically occur in the context of skin changes attributed to chronic venous insufficiency. The 2 forms of AB-(1) the LV-AB complex and (2) AB in the context of chronic venous insufficiency-are unrelated and require separate diagnostic and therapeutic approaches. Using a modified Delphi method, we have developed an international consensus document on the diagnosis and management of LV. Individual sections of this document provide advice on diagnosis and management of LV.