Introduction: Livedoid vasculitis is a painful ulcerative condition affecting the legs that is often difficult to treat. In this case series, the clinical profile of 6 patients with livedoid vasculitis and their treatment response to aspirin and pentoxifylline are reported.Materials and Methods: This is an open trial. Investigations to exclude secondary causes of livedoid vasculitis were done. Skin biopsies were performed for histology and direct immunofluorescence. Four patients were treated with pentoxifylline and 2 with aspirin. Response to treatment was assessed at the third and sixth weeks. Thereafter, treatment was individualised according to each patient’s clinical response. Results: Only 1 out of 6 patients had a good response. This patient was treated with pentoxifylline. Most patients required treatment with drugs such as prednisolone, colchicine and azathioprine to control disease activity after the trial period. Conclusion: Pentoxifylline or aspirin did not result in significant improvement for most of our patients when used alone. Combination with immunosuppressive treatment yielded better results.
Livedoid vasculitis is a clinicopathological entity that has variously been referred to as atrophie blanche, livedoid vasculopathy or segmental hyalinising vasculitis. It presents with purpuric lesions and recurrent, painful ulcerations of the lower limbs which result in depressed, atrophic white scars.
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