[Liveoid vasculopathy with combined thrombophilia: efficacy of iloprost].
BACKGROUND
Livedoid vasculopathy is characterized by early, focal painful purpuric lesions of the lower skin extremities without histologic finding of small vessel vasculitis.


METHODS
A 38-year-old man was seen in our unit for painful purpuric lesions of both feet localized on toes and external sides. Skin biopsy showed dermic vessel thrombosis and endothelial cell proliferation. Lupus anticogulant antibody was positive in association with a heterozygous factor V (Leiden) gene mutation (G1691A). Anticoagulation failed to relieve pain and cutaneous lesions. Intravenous iloprost, a prostacylcin analogous (Ilomedine) was dramatically and rapidly effective in our patient.


CONCLUSIONS
Livedoid vasculopathy is a cutaneous affection related to vascular thrombotic events in which thrombophilia plays a central role. Iloprost might be an interesting alternative treatment of painful purpuric lesions when anticoagulant treatments are ineffective.
Magy
N
N
Service de médecine interne et immunologie clinique, hôpital Jean-Minjoz, CHU, 2, boulevard Fleming, 25030 Besançon, France.
Algros
M P
MP
Racadot
E
E
Gil
H
H
Kantelip
B
B
Dupond
J L
JL
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D005528:Foot / Q000098:blood supply / Q000473:pathology; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage / Q000494:pharmacology*; D007262:Infusions, Intravenous; D008297:Male; D010146:Pain / Q000209:etiology; D017445:Skin Diseases, Vascular / Q000150:complications / Q000188:drug therapy*; D019851:Thrombophilia / Q000209:etiology*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology*
D000925:Anticoagulants; D014665:Vasodilator Agents; D016285:Iloprost