Abstract

Livedoid vasculopathy (LV) is a dermatopathy characterized by skin ulceration consequential to chronic thombo-occulusive process. It is sometimes idiopathic or occurs consociated with chronic venous disease, thrombophelibitis, hyper coagulable state, protein C deficiency, factor VII deficiency, antiphospholipid antibody syndrome and hyperhomocystinemia. LV presents as grouped, painful, voilaceous macules, papules and patches with a proclivity to ulcerate over a long span of time. Dependent sites of the legs are affected, often bilaterally. Discrete ulcers are painful, small, angulated and coalesce at places to form bigger ulcers. On healing they leave behind atrophic, porcelain scars, surrounded by telangiectasia termed "atrophie blanche". We present a case of LV in a 22 year old female who presented with painful ulcers around the ankles for 8 months. Ulcers were covered with thick crust, and were painful on palpation. Skin biopsy revealed dermal vessel walls thickening and hyaline changes and their lumen had fibrin deposition, intra-luminal thrombosis, thus confirming the diagnosis of livedoid vasculopathy. Ulcers healed on treatment with pentoxifylline and colchicine.

Key words: Atrophie blanche, Livedoid vasculopathy, Small vessel venulitis, Ulcer