title: Livedoid vasculopathy and high levels of lipoprotein (a): response to danazol.
abstract: Livedoid vasculopathy (LV) is a thrombo occlusive disorder presenting with recurrent painful ulcers of lower extremities. Association of LV with increased level of lipoprotein (a) (LP(a)), a risk factor for cardiovascular disease, has been reported. Danazol has been used with success in the management of LV, but none of the previous studies looked at the correlation between response to the treatment and level of LP(a). The aim of this study was to demonstrate the efficacy of low-dose danazol in the treatment of LV and its effects on LP(a). We present four cases with LV who were successfully treated with low-dose danazol, assessing the clinical characteristics and laboratory tests including the level of LP(a). The average age of the patients was 45 years and the mean duration of the disease was 19 years. The treatment regime of danazol 200 mg daily led to complete healing of ulcers and reduction in pain and a 70% (ranging from 52 to 87%) reduction in the level of LP(a). The limitation of this study is "small sample size." In our patients with LV, low-dose danazol led to clinical improvement along with significant reduction in the level of LP(a).
authors.affiliation: Dermatology, Dermatology Sao Paulo, Hospital das Clínicas da Faculdade de Medicina da USP.
authors.forename: Paulo Ricardo
authors.initials: PR
authors.lastname: Criado
authors.affiliation: Dermatology Department, São Paulo University, São Paulo, Brazil.
authors.forename: Danielle Priscilia
authors.initials: DP
authors.lastname: de Souza EspinelI
authors.affiliation: Dermatology Department, São Paulo University, São Paulo, Brazil.
authors.forename: Neusayuriko Sakai
authors.initials: NS
authors.lastname: Valentef
authors.affiliation: Medicine (Dermatology), University of Toronto, Toronto, Ontario, Canada.
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Alavi
authors.affiliation: Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner
mesh_terms: D000328:Adult; D003613:Danazol / Q000008:administration & dosage / Q000627:therapeutic use*; D004965:Estrogen Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000209:etiology; D017270:Lipoprotein(a) / Q000097:blood*; D054068:Livedo Reticularis / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D004965:Estrogen Antagonists; D017270:Lipoprotein(a); D003613:Danazol
keywords: pharmacology; skin signs of systemic disease; therapy-systemic