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

Bounfour, T.; Bouaziz, Jean‐David; Bézier, M.; Petit, Antoine; Viguier, Manuelle; Rybojad, M.; Bagot, M.

doi:10.1111/j.1365-4632.2012.05826.x

Cited by 23 publications

(30 citation statements)

References 13 publications

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“…These patients were successfully treated with IVIG: 94% had at least > 50% improvement with 63% going to complete remission. Our data were concordant with previous studies and justified the use of IVIG as a second-line treatment after unsuccessful use of heparin anticoagulation (16)(17)(18)(19).…”

Section: Discussionsupporting

confidence: 91%

“…Most treatments are based on anticoagulation (1,3). Several retrospective studies and case reports have shown a good response to intravenous immunoglobulins (IVIG) in refractory patients (16)(17)(18)(19). However, in the absence of large prospective controlled studies, there is no recommendation on the dose or duration of medication and as such the optimal therapeutic regimen is unknown.…”

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confidence: 99%

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Livedoid Vasculopathy: A French Observational Study Including Therapeutic Options

Gardette¹,

Moguelet²,

Bouaziz³

et al. 2018

Acta Derm Venerol

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Livedoid vasculopathy is a rare thrombotic cutaneous disease. This observational study aimed to assess the clinical and biological features of livedoid vasculopathy and the efficacy of treatments. Patients enrolled had typical livedoid vasculopathy both clinically and histologically. Investigation of thrombophilia was performed. Electromyography was undertaken in the presence of symptoms suggesting peripheral neuropathy. Eighteen women and 8 men were included, with a mean age of 35.5 years at onset. Twenty patients had at least one thrombophilia factor. Ten patients had a peripheral neuropathy with 2 of these patients demonstrating a specific thrombo-occlusive vasculopathy on muscle biopsy. Anticoagulation with low molecular weight heparin was the most prescribed therapy and was associated with the best outcome (effective in 14 patients). Eight patients had severe disease refractory to anticoagulation and required intravenous immunoglobulins, producing a good response in 6 patients.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Livedoid Vasculopathy: A French Observational Study Including Therapeutic Options

Gardette¹,

Moguelet²,

Bouaziz³

et al. 2018

Acta Derm Venerol

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“…There have been three case series of LV treated with IVIg thus far . The results of our series are similar to the previous reports in that three cycles of monthly IVIg was effective and improvement in pain was achieved faster and was more significant compared with erythema and ulceration ( p = 0.041).…”

Section: Discussionsupporting

confidence: 87%

Pulsed intravenous immunoglobulin therapy in refractory ulcerated livedoid vasculopathy: seven cases and a literature review

Kim

Yoon

Park

et al. 2015

Dermatologic Therapy

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Livedoid vasculopathy (LV) is a thrombotic vasculopathy of the skin of unknown origin. No treatment has been validated in this indication, but case reports demonstrated successful use of intravenous immunoglobulins (IVIg) in LV. We assessed the efficacy and tolerability of 2 g/kg IVIg therapy every month for 2∼3 cycles in patients with refractory LV. We analyzed the efficacy, side effects and recurrence after long-term follow-up (51.9 ± 14.0 months) in seven patients with LV treated with 2 g/kg of IVIg. Mean clinical score of sum of erythema, ulceration and pain index (each: 0-3) was 5.7 ± 0.9 before the therapy and significantly lower after therapy (1.1 ± 0.5) (p = 0.001). Even after just one cycle of IVIg, the score decreased significantly from 5.7 ± 0.9 to 3.7 ± 0.9 (p = 0.002), especially the pain score. In one patient, LV has not recurred for over 7 years; six patients experienced recurrence after a mean of 12.7 ± 2.8 months. Out of the six patients, two patients were re-administered IVIg whereas the others were well controlled by conventional therapy. We propose that IVIg is a rapid, effective, and safe therapeutic option in LV refractory to other treatment modalities.

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“…[12][13][14][15][16][17][18][19][20][21][22][23][24] A number of therapies have been proposed, including anticoagulant, fibrinolytic, antiplatelet, immunosuppressant, and immunomodulator therapy, as well as hyperbaric oxygen; however, IVIG was felt to be the best option. 12-24 A number of studies supported the use of IVIG in the treatment of LV and demonstrated good outcomes 14,15,[21][22][23] with minimal adverse effects, 24 and it has been shown to benefit those with difficultto-treat LV. 25 These findings led us to initially seek IVIG as a treatment option.…”

Section: Thrombotic Vasculopathy In a Patient With Initially Undetectmentioning

confidence: 99%

Thrombotic Vasculopathy in a Patient With Initially Undetected Breast Cancer

Emily

Jonida²,

Rachita³

et al. 2014

JCR: Journal of Clinical Rheumatology

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

Abstract: 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.

Cited by 23 publications

References 13 publications

Livedoid Vasculopathy: A French Observational Study Including Therapeutic Options

Livedoid Vasculopathy: A French Observational Study Including Therapeutic Options

Pulsed intravenous immunoglobulin therapy in refractory ulcerated livedoid vasculopathy: seven cases and a literature review

Thrombotic Vasculopathy in a Patient With Initially Undetected Breast Cancer

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