Espinel Danielle P G S, Di Giacomo Thais B, Pincelli Thais P, Pereira Naiura V, Sotto Miriam N, Kirsner Robert S, Criado Paulo R
Dermatology Department of Hospital das Clínicas, University of Sao Paulo Medical School, São Paulo, Brazil.
Laboratory of Investigative Dermatology and Immunodeficiencies, University of Sao Paulo Medical School, São Paulo, Brazil.
J Cutan Pathol. 2017 Dec;44(12):1033-1037. doi: 10.1111/cup.13043. Epub 2017 Oct 13.
Coagulation disorders contribute to the development of livedoid vasculopathy (LV). Elevated plasma levels of lipoprotein(a) [Lp(a)] are an independent risk factor for the development of cardiovascular disease and associated with hypercoagulable states. Increased serum Lp(a) levels have been reported in patients with LV and may have an important role in the pathogenesis of LV.
To investigate Lp(a) expression in skin lesions and circulating serum Lp(a) levels in patients with LV.
Skin biopsy samples from 38 patients (27 women and 11 men) with active lesions diagnosed as LV and 9 samples of normal skin (5 women and 4 men) from control patients without LV were evaluated for skin expression of Lp(a) by immunohistochemistry. Plasma levels of Lp(a) were analyzed by immunoturbidimetry.
We found that lesional skin in patients with LV expressed 10-fold higher Lp(a) immunostaining than controls. High plasma levels of Lp(a) were observed in LV patients. We did not find a correlation (P = .02) between expression of Lp(a) in the skin and plasma levels of Lp(a) in patients with LV.
Increased Lp(a) expression in lesional skin of LV patients suggests the role of Lp(a) in the thrombo-occlusive vasculopathy observed in this disease.
凝血功能障碍促使类脂质渐进性坏死性血管病（LV）的发生。脂蛋白(a)[Lp(a)]血浆水平升高是心血管疾病发生的独立危险因素，并与高凝状态相关。LV患者中已报道血清Lp(a)水平升高，其可能在LV的发病机制中起重要作用。
研究LV患者皮肤病变中Lp(a)的表达及循环血清Lp(a)水平。
对38例（27例女性和11例男性）诊断为LV且有活动性病变的患者的皮肤活检样本，以及9例来自无LV的对照患者的正常皮肤样本（5例女性和4例男性）进行免疫组织化学评估，以检测Lp(a)的皮肤表达。采用免疫比浊法分析血浆Lp(a)水平。
我们发现LV患者的病变皮肤Lp(a)免疫染色比对照组高10倍。LV患者中观察到血浆Lp(a)水平较高。我们未发现LV患者皮肤中Lp(a)的表达与血浆Lp(a)水平之间存在相关性（P = 0.02）。
LV患者病变皮肤中Lp(a)表达增加表明Lp(a)在该疾病中观察到的血栓闭塞性血管病中起作用。
