Department of Dermatology, Nippon Medical School, Tokyo 113-8602, Japan.
J Dermatol. 2010 Jan;37(1):98-101. doi: 10.1111/j.1346-8138.2009.00754.x.
We report herein a case of a 28-year-old woman with persistent livedo racemosa and recurrent ulcerations on the lower extremities. The clinical presentation, together with histopathological findings of vascular occlusion without overt vasculitis in the dermis, led to the diagnosis of livedoid vasculopathy. The patient experienced recurrence of ulcerations and developed peripheral neuropathy affecting the distal extremities during the course of treatment with sarpogrelate hydrochloride. The skin lesions and neurological symptoms improved dramatically after adding low-dose warfarin potassium to the treatment regimen. This case suggests that administration of low-dose warfarin is an effective therapy of choice for patients with livedoid vasculopathy.
我们在此报告一例 28 岁女性,其下肢持续性网状青斑和反复发作的溃疡。临床表现,加上真皮血管闭塞而无明显血管炎的组织病理学发现,导致了 livedoid 血管病变的诊断。在服用盐酸沙格雷酯治疗过程中,患者出现溃疡复发,并发展为影响远端肢体的周围神经病。在治疗方案中添加小剂量华法林钾后,皮肤病变和神经症状显著改善。该病例表明,低剂量华法林的给药是 livedoid 血管病变患者的有效治疗选择。