Livedoid Vasculitis in a Patient With Sjogren Syndrome Successfully Treated With Methotrexate

Abstract

Introduction: Cutaneous vasculitis occurs in a sizable minority of patients with Sjogren syndrome. In addition, their response to different modalities of therapy is variable. Case Description: We present a case of a 66-year-old female with Sjogren syndrome cutaneous vasculitis in whom combination treatment with Rituximab and Azathioprine failed to show a favorable response. However, methotrexate proved to be an excellent alternative. Discussion: In cutaneous vasculitis, in addition to the necessary local therapy applied to the affected limbs, methotrexate produced a complete response when other treatment modalities failed. Therefore, it may be advisable to use methotrexate to treat cutaneous vasculitis before trying Rituximab. Conclusion: In cutaneous vasculitis associated with Sjogren syndrome, methotrexate can be an early effective therapeutic strategy.

Tratamento De Vasculite Livedoide Secundária a Trombofilias: Revisão Integrativa De Literatura

“…Os autores mantiveram o uso desse medicamento por 6 meses, porém novas úlceras se desenvolveram, e, dessa forma, suspenderam o uso tanto do rituximabe quanto da azatioprina. Iniciaram com metotrexato 10mg junto com ácido fólico 10mg, semanalmente por via oral (VO), observando melhora do quadro e cicatrização das úlceras sem o surgimento de novas lesões 19 .…”