What is Livedoid Vasculopathy?
Livedoid Vasculopathy is an extremely rare vascular condition in which the affected patient develops painful ulcerations in the lower extremities. In Livedoid Vasculopathy, the ulcerations are specific only to leg and foot which means they do not occur anywhere else in the body. Livedoid Vasculopathy was previously known by the name of livedo vasculitis and livedoid vasculitis but since research proved that it not caused due to inflammation of the blood vessel it prompted a change in the name to Livedoid Vasculopathy.
What are the Causes of Livedoid Vasculopathy?
The exact cause of Livedoid Vasculopathy is still unclear but researchers have come up with various theoretical explanations for this condition which include abnormalities within the walls of the blood vessels and circulation abnormalities. It is believed that Livedoid Vasculopathy may be caused due to a mixture of several different abnormalities clubbed into one resulting in clotting within the blood vessels in the lower extremities. This clotting results in necrosis of overlying skin, development of ulceration, and slow healing rate.
What are the Symptoms of Livedoid Vasculopathy?
The affects of Livedoid Vasculopathy is seen in the lower extremities, the legs, ankles, and foot. It is normally bilateral. The livedoid vasculopathy symptoms include:
- Mildly painful red spots which gradually progress to tender irregular ulcers
- Livedo reticularis
- Raynaud phenomenon
- Acrocyanosis in some cases.
How is Livedoid Vasculopathy Diagnosed?
The diagnosis of Livedoid Vasculopathy starts with taking a detailed history of the patient as to when the symptoms started. The next step towards diagnosis is conducting a detailed physical examination of the area with careful palpation of the lower extremities looking for tenderness and pain. Once Livedoid Vasculopathy is suspected, then a skin biopsy is taken of the ulcer which confirms the diagnosis of Livedoid Vasculopathy. The physician may also order some investigations for confirmation of the diagnosis of Livedoid Vasculopathy. These investigations include:
- Complete blood count
- Coagulation studies
- Connective tissue antibodies
- Lupus coagulant
- Anticardiolipin antibodies
- Homocysteine levels.
How is Livedoid Vasculopathy Treated?
The main aim of treatment for Livedoid Vasculopathy is to reduce pain and preventing the development of new ulcers and treating the already formed ulcers. The physician will advise to protect the area from bruises, abrasions, allergens, and ill fitting shoe wear. The physician will also remove dead tissue from the ulcers. Antibiotics will be prescribed for treating any infection present. The patient will be advised to raise the leg above the level of the heart. The patient will also be asked to apply compresses, take plenty of bed rest while the ulcer resolves. The patient if a smoker will be asked to avoid smoking as it reduces peripheral blood flow. The patient may also be given certain medications for treatment of Livedoid Vasculopathy to include:
- Oral warfarin
- Antiinflammatory medications
- Phenformin for dissolving blood clots if present
- Folic acid.
What is the Prognosis of Livedoid Vasculopathy?
Livedoid Vasculopathy is a condition which will wax and wane with its period of remissions and exacerbations. Research suggests a patient may suffer for 3 months to even up to 20 years from Livedoid Vasculopathy.