title: Successful treatment of livedo vasculitis with beraprost sodium: a possible mechanism of thrombomodulin upregulation.
abstract: BACKGROUND
  Livedo vasculitis is thought to be a thrombogenic disorder. We demonstrated that thrombomodulin (TM) expression on the endothelial cells in livedo vasculitis was markedly reduced, while blood tests of coagulation and fibrinolytic activities were within the normal range.
  
  
  OBJECTIVE
  Since prostacyclin (PGI2) upregulates the TM expression of endothelial cells, we tried a PGI2 analogue for the treatment of livedo vasculitis.
  
  
  METHODS
  Four patients with livedo vasculitis were started on a regimen of beraprost sodium (120 micrograms daily). Additional intake of low-dose aspirin was combinated with a maintenance dose of beraprost sodium (60 micrograms daily).
  
  
  RESULTS
  All 4 patients experienced a clinical improvement with a combination therapy with beraprost sodium and low-dose aspirin.
  
  
  CONCLUSIONS
  We propose that PGI2 analogue therapy is useful for the treatment of livedo vasculitis, since the drug upregulates TM expression in this disorder.
authors.affiliation: Department of Dermatology, Kanazawa University School of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tsutsui
authors.forename: F
authors.initials: F
authors.lastname: Shirasaki
authors.forename: M
authors.initials: M
authors.lastname: Takata
authors.forename: K
authors.initials: K
authors.lastname: Takehara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D002648:Child; D004359:Drug Therapy, Combination; D004817:Epidermis / Q000187:drug effects / Q000473:pathology; D011464:Epoprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D018180:Thrombomodulin / Q000187:drug effects* / Q000378:metabolism; D016896:Treatment Outcome; D015854:Up-Regulation; D014657:Vasculitis / Q000188:drug therapy* / Q000473:pathology
chemical_list: D010975:Platelet Aggregation Inhibitors; D018180:Thrombomodulin; C048081:beraprost; D011464:Epoprostenol; D001241:Aspirin