A ten-year retrospective study on livedo vasculopathy in Asian patients.
- Author:
Emily Y GAN
1
;
Mark B Y TANG
;
Suat Hoon TAN
;
Sze Hon CHUA
;
Audrey W H TAN
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Aged; Asian Continental Ancestry Group; Cellulitis; complications; epidemiology; pathology; Female; Humans; Livedo Reticularis; complications; epidemiology; pathology; Male; Middle Aged; Retrospective Studies; Singapore; epidemiology; Skin; pathology; Time Factors; Young Adult
- From:Annals of the Academy of Medicine, Singapore 2012;41(9):400-406
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONThis study aims to analyse the clinico-epidemiological characteristics of Asian patients diagnosed with livedo vasculopathy (LV).
MATERIALS AND METHODSWe performed a retrospective analysis of all patients diagnosed with LV from 1997 to 2007 at our centre.
RESULTSSeventy 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.
CONCLUSIONLV 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.