Atrophie Blanche

Alavi, Afsáneh; Hafner, Jürg; Dutz, Jan P.; Mayer, Dieter; Sibbald, R. Gary; Criado, Paulo Ricardo; Senet, Patricia; Callen, Jeffery P.; Phillips, Tania J.; Romanelli, Marco; Kirsner, Robert S.

doi:10.1097/01.asw.0000455098.98684.95

Cited by 21 publications

(8 citation statements)

References 44 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is often bilateral, involving the skin of the gaiter area around the dorsal ankle and foot. It is more common in women(44). Reported etiologies for LV include autoimmune diseases (45–53), hypercoagulable states and situations with impaired fibrinolysis(54).…”

Section: Differential Diagnosis Of Vasculitic Woundsmentioning

confidence: 99%

Vasculitic and autoimmune wounds

Shanmugam

Angra

Rahimi

et al. 2017

Journal of Vascular Surgery: Venous and Lymphatic Disorders

View full text Add to dashboard Cite

Chronic wounds are a major cause of morbidity and mortality. Approximately 20–23% of non-healing wounds that are refractory to vascular intervention have other etiologies including vasculitis, pyoderma gangrenosum and other autoimmune diseases. The purpose of this article is to review the autoimmune and coagulopathic diseases that are commonly associated with leg ulceration. OBJECTIVES To review the literature across medical and surgical specialties with regards to refractory chronic wounds associated with vasculitis and autoimmune diseases and to delineate clinical outcomes of these wounds in response to vascular and other interventions. METHODS An electronic search encompassing MEDLINE®, PubMed®, Cochrane Library and Scopus ® was completed using the following search terms: rheumatoid arthritis; systemic sclerosis; systemic lupus erythematosus; ANCA associated vasculitis; mixed connective tissue disease; antiphospholipid syndrome; pyoderma gangrenosum; thromboangiitis obliterans; cryoglobulinemia; hydroxyurea; sickle-cell; atrophie blanche; livedoid vasculitis; cholesterol emboli; calciphylaxis; antiphospholipid antibodies; prothrombotic; combined with the terms: chronic wound and leg ulcer. Full text articles published in English up to March 1, 2016 that investigated the clinical outcomes of chronic wounds associated with autoimmune diseases were included. Review articles and evaluations of management of chronic wounds were also reviewed. Primary outcomes included in the review were amputation, ulcer healing, reduction in wound size, overall survival and freedom from reintervention. Owing to the heterogeneity of data reporting among articles, qualitative analysis is also reported. CONCLUSIONS Autoimmune and vasculitic etiologies should be considered in patients with chronic wounds who do not respond to appropriate vascular intervention and standard local wound care. A multidisciplinary approach with the involvement of rheumatology allows investigation for underlying systemic disease and improves clinical outcomes for many of these challenging patients.

show abstract

Section: Differential Diagnosis Of Vasculitic Woundsmentioning

confidence: 99%

Vasculitic and autoimmune wounds

Shanmugam

Angra

Rahimi

et al. 2017

Journal of Vascular Surgery: Venous and Lymphatic Disorders

View full text Add to dashboard Cite

show abstract

“…Lesions are often bilateral, involving the dorsal ankle and foot. Atrophie blanche and LV is more common in women (42). Reported etiologies for LV include autoimmune diseases (43–51), hypercoagulable states and situations with impaired fibrinolysis (52).…”

Section: Occlusive Diseases Resulting In Ulcersmentioning

confidence: 99%

Vasculitic Diseases and Prothrombotic States Contributing to Delayed Healing in Chronic Wounds

Shanmugam

2016

Curr Derm Rep

View full text Add to dashboard Cite

PURPOSE Autoimmune diseases are a common cause of delayed wound healing and should be considered in patients with chronic wounds who do not respond to local wound care or who fail skin grafting in the absence of infection. RECENT FINDINGS Epidemiologic studies have shown that, of patients with chronic wounds evaluated in specialized wound healing clinics, 20–23% have autoimmune etiologies for their wounds including vasculitis, rheumatoid arthritis, systemic lupus erythematosus, scleroderma, pyoderma gangrenosum and other autoimmune diseases. SUMMARY In this article autoimmune diseases known to be associated with chronic wounds and delayed wound healing are reviewed and the importance of a multidisciplinary approach for patients with chronic wounds, with involvement of rheumatology and dermatology is highlighted. This approach allows for investigation of underlying systemic disease and improves clinical outcomes for many of these challenging patients.

show abstract

“…It is also found in chronic venous insufficiency and other thrombophilic diseases such as antiphospholipid syndrome. 3 AB lesions in patients with LV are located on the medial and lateral ankles and extend to the dorsum of the feet, and they may or may not be preceded by ulcers. In contrast, AB lesions in patients with venous insufficiency are located on the medial ankles and are usually preceded by venous ulcers.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, AB lesions in patients with venous insufficiency are located on the medial ankles and are usually preceded by venous ulcers. 3 Duplex ultrasonography can aid in distinguishing the two entities. 4 Given the location of the leg ulcers and the normal venous Doppler ultrasonographic findings in our patient, LV was more likely than venous insufficiency.…”

Section: Discussionmentioning

confidence: 99%

Livedoid Vasculopathy Secondary to Protein C Deficiency: A Case Successfully Treated With Rivaroxaban

Chaisrimanepan

Tienthavorn²

2022

International Journal of Dermatology and Venereology

View full text Add to dashboard Cite

Introduction: Livedoid vasculopathy is a chronic noninflammatory skin disease secondary to hypercoagulable states. No therapeutic guideline has yet been established for livedoid vasculopathy. We herein report a case of livedoid vasculopathy secondary to protein C deficiency that was successfully treated with rivaroxaban. Case presentation: A 31-year-old Thai woman who had been diagnosed with livedoid vasculopathy 10 years previously presented with a 2-month history of worsening leg ulcers and failure to respond to aspirin, colchicine, and pentoxifylline. Further investigations confirmed protein C deficiency. Rivaroxaban was initiated, and clinical improvement was achieved in 8 weeks. Discussion: When livedoid vasculopathy is confirmed by skin biopsy, additional investigations for hypercoagulable states should be performed to exclude secondary causes. Identification of the causes of livedoid vasculopathy can direct physicians to therapeutic options based on previously reported cases of successful treatment. Our patient, whose livedoid vasculopathy was caused by protein C deficiency, responded well to rivaroxaban. Conclusion: Protein C deficiency results in a hypercoagulable state, and affected patients can present with livedoid vasculopathy. The anticoagulant rivaroxaban has been beneficial in the treatment of livedoid vasculopathy.

show abstract

Atrophie Blanche

Cited by 21 publications

References 44 publications

Vasculitic and autoimmune wounds

Vasculitic and autoimmune wounds

Vasculitic Diseases and Prothrombotic States Contributing to Delayed Healing in Chronic Wounds

Livedoid Vasculopathy Secondary to Protein C Deficiency: A Case Successfully Treated With Rivaroxaban

Contact Info

Product

Resources

About