title: Intravenous immunoglobulins in difficult-to-treat ulcerated livedoid vasculopathy: five cases and a literature review.
abstract: BACKGROUND
  Livedoid vasculopathy (LV) is a thrombotic vasculopathy of the skin of unknown origin. No treatment has been validated in this indication, but case reports suggest the successful use of intravenous immunoglobulins (IVIG) in LV.
  
  
  METHODS
  Outcomes in five patients treated with IVIG for treatment-resistant ulcerated LV were retrospectively analyzed.
  
  
  RESULTS
  Treatment with IVIG induced complete remission (based on clinical evaluation and a pain-related visual analog scale) in four patients but was ineffective in one patient. Three patients relapsed; the median time to relapse was 10.7 months. Re-treatment with IVIG in these three patients was successful.
  
  
  CONCLUSIONS
  These cases confirm previous reports that IVIG seems to be a rapid, effective, and safe treatment for patients with idiopathic refractory ulcerated LV. However, a placebo-controlled study is mandatory to confirm these results.
authors.affiliation: Department of Dermatology, AP-HP, Saint Louis Hospital and Paris 7 Diderot Sorbonne University, Paris, France.
authors.forename: Touda
authors.initials: T
authors.lastname: Bounfour
authors.forename: Jean-David
authors.initials: JD
authors.lastname: Bouaziz
authors.forename: Maud
authors.initials: M
authors.lastname: Bézier
authors.forename: Antoine
authors.initials: A
authors.lastname: Petit
authors.forename: Manuelle
authors.initials: M
authors.lastname: Viguier
authors.forename: Michel
authors.initials: M
authors.lastname: Rybojad
authors.forename: Martine
authors.initials: M
authors.lastname: Bagot
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D054068:Livedo Reticularis / Q000276:immunology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012883:Skin Ulcer / Q000276:immunology / Q000628:therapy*; D013927:Thrombosis / Q000276:immunology / Q000628:therapy*; D055815:Young Adult
chemical_list: D016756:Immunoglobulins, Intravenous