Warfarin therapy for livedoid vasculopathy associated with cryofibrinogenemia and hyperhomocysteinemia.
BACKGROUND
Livedoid vasculopathy is an idiopathic, chronic disorder manifested by painful, purpuric macules on the lower extremities that superficially ulcerate, resulting in atrophic, stellate scars with peripheral telangiectasias and hyperpigmentation.


METHODS
A 50-year-old man presented with recurrent, painful ulcerations on the medial aspect of his malleoli and calves. The clinical presentation, histologic findings, and results of laboratory evaluation confirmed the diagnosis of livedoid vasculopathy in this case. Despite being refractory to treatment with multiple other medications, the lesions responded dramatically to oral warfarin sodium therapy.


CONCLUSIONS
Treatment with warfarin may be a beneficial therapy for patients with livedoid vasculopathy.
Browning
Catherine E
CE
Division of Dermatology, Department of Medicine, University of Louisville, KY, USA.
Callen
Jeffrey P
JP
D000925:Anticoagulants / Q000627:therapeutic use*; D001706:Biopsy; D003449:Cryoglobulinemia / Q000097:blood / Q000150:complications*; D003450:Cryoglobulins / Q000378:metabolism*; D003937:Diagnosis, Differential; D015241:Fibrinogens, Abnormal / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D017445:Skin Diseases, Vascular / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D014859:Warfarin / Q000627:therapeutic use*
D000925:Anticoagulants; D003450:Cryoglobulins; D015241:Fibrinogens, Abnormal; C041874:cryofibrinogen; D014859:Warfarin