A ten-year retrospective study on livedo vasculopathy in Asian patients.
BACKGROUND
This study aims to analyse the clinico-epidemiological characteristics of Asian patients diagnosed with livedo vasculopathy (LV).


METHODS
We performed a retrospective analysis of all patients diagnosed with LV from 1997 to 2007 at our centre.


RESULTS
Seventy patients were diagnosed with LV with a mean age of 39 years, female: male ratio of 3:1 and no racial predilection. Most cases remained purely cutaneous, presenting with painful leg ulcers and atrophie blanche. Peripheral neuropathy was the only extra-cutaneous complication (9%). In patients who were screened, associations included hepatitis B (7%) and hepatitis C (4%), positive anti-nuclear antibody (14%), positive anti-myeloperoxidase antibody (5%), positive anti-cardiolipin antibodies (7%) and positive lupus anticoagulant (2%). In 49 patients who achieved remission, 55% required combination therapy, most commonly with colchicine, pentoxifylline and prednisolone. In those treated successfully with monotherapy, colchicine was effective in 59% followed by prednisolone (17.5%), pentoxifylline (17.5%) and aspirin (6%). Mean follow-up period was 50 months.


CONCLUSIONS
LV in Asian patients is a high morbidity, chronic relapsing ulcerative skin condition. Most patients require induction combination therapy for remission. As further evidence emerges to support a procoagulant pathogenesis, a standardised protocol is needed to investigate for prothrombotic disorders during diagnosis.
National Skin Centre, 1 Mandalay Road, Singapore. emily.ganyp@gmail.com
Emily Y
EY
Gan
Mark B Y
MB
Tang
Suat Hoon
SH
Tan
Sze Hon
SH
Chua
Audrey W H
AW
Tan
D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002481:Cellulitis / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D054068:Livedo Reticularis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D012867:Skin / Q000473:pathology*; D013997:Time Factors; D055815:Young Adult