Livedoid vasculopathy

Bei der Livedovaskulopathie kommt es durch eine Gefa ss okklusion zur Ischamie mit anschlie ss ender Ulzeration der Haut. Die Erkrankung hat chronisch rezidivierende Verlaufe und tritt ausschlie ss lich an der unteren Extremitat auf. Dieser Artikel beschreibt die klinischen Besonderheiten und die Therapieoptionen der Livedovaskulopathie. Die Empfehlungen stehen im Einklang mit der aktuellen S1-Leitlinie Diagnostik und Therapie der Livedovaskulopathie". Abstract Livedovasculopathy is a chronic and recurrent disease in which an insufficient perfusion of the skin leads to ischemia and subsequent ulceration. Painful, recurrent ulcerations on the lower legs are characteristic. A clinical triad consisting of livedo racemosa, ulceration and atrophie blanche is typical. The disease manifests itself exclusively in the lower extremity and especially in the malleolar region. Typically, the patients describe burning pain, which is limited to the place of manifestation does not show any seasonal accumulation. The diagnosis of LV is based on the clinical image and histology. The histological confirmation should be carried out in the acute stage of ischemia. The typical fibrin thrombi can be detected with a spindle biopsy from the peripheral area of the manifestation. First-line therapy consists of low molecular weight heparin, direct oral anticoagulants, or intravenous immunoglobulins. The rapid diagnosis and initiation of therapy to avoid irreversible ulcerations is crucial for the long-term management.