Association between peripheral vascular endothelial dysfunction and livedoid vasculopathy

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• 作者：Chih-Hsun Yang ; MD^a ; Su-Chin Shen ; MD^b ; Rosaline Chung-Yee Hui ; PhD^a ; Yu-Huei Huang ; MD^a ; Pao-Hsien Chu ; MD^c ; Wan-Jing Ho ; MD^c ; ^{auditory@adm.cgmh.org.tw}
• 关键词：endothelial dysfunction ; endothelium-dependent flow-mediated vasodilation ; livedoid vasculopathy
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2012
• 期刊代码：200_01909622
• 类别：med
• 出版时间：July, 2012
• 卷：67
• 期：1
• 页码：107-112
• 文件大小：141 K

摘要

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Background

Livedoid vasculopathy (LV) is a disease characterized by multiple painful and recurrent ulcerations on the feet, accompanied by atrophic scars. Many researchers suggest that a hypercoagulable status is the pathogenetic factor for LV. However, the cause of LV remains elusive.

Objective

We sought to determine if endothelial dysfunction is present in patients with LV.

Methods

This prospective study included 16 patients with LV and active ulcers and 16 matched control subjects. We reviewed detailed clinical parameters, including antinuclear antibody, high-sensitivity C-reactive protein, protein C, protein S, homocysteine, anti-SSA, anti-SSB, anticardiolipin antibody, and serum lipid profiles. Flow-mediated vasodilation of the brachial artery was used as an indicator of vascular endothelial function using high-resolution 2-dimensional ultrasonic imaging.

Results

Blood pressure, blood biochemistry, high-sensitivity C-reactive protein, and homocysteine were not significantly different in patients with LV and control subjects. Nitroglycerin-mediated vasodilation was not significantly different in patients with LV and control subjects. However, flow-mediated vasodilation was much less in patients with LV than in the control group (3.58 卤 2.32%vs 7.51 卤 2.40%, P < .001).

Limitations

The study was performed at a single site with a limited sample size.

Conclusion

Peripheral vascular endothelial dysfunction was demonstrated in patients with LV by reduction of brachial flow-mediated vasodilation.