Intravenous immunoglobulins in difficult-to-treat ulcerated livedoid vasculopathy: five cases and a literature review

Int J Dermatol. 2013 Sep;52(9):1135-9. doi: 10.1111/j.1365-4632.2012.05826.x. Epub 2013 Mar 14.

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Livedo Reticularis / immunology
  • Livedo Reticularis / therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Skin Ulcer / immunology
  • Skin Ulcer / therapy*
  • Thrombosis / immunology
  • Thrombosis / therapy*
  • Young Adult

Substances

  • Immunoglobulins, Intravenous