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Primary livedoid vasculopathy associated with mononeuritis multiplex.

Steven Krueger, Riley McLean, Shinya Amano

  • 1Department of Dermatology, University of Massachusetts Medical School, Worcester, MA Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA. Leah.Belazarian@umassmemorial.org.

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Livedoid vasculopathy (LV) can cause mononeuritis multiplex, a rare nerve complication. Early diagnosis and a team approach are crucial for managing this painful condition.

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Area of Science:

  • Vascular Medicine
  • Neurology

Background:

  • Livedoid vasculopathy (LV) is a rare chronic vascular disorder characterized by painful ulcerations, typically on the lower extremities.
  • While the etiology of LV is multifactorial, it is associated with thrombotic events and inflammation.

Observation:

  • A 40-year-old woman with biopsy-confirmed livedoid vasculopathy presented with painful lower extremity ulcerations.
  • Despite successful treatment of ulcerations with aspirin, pentoxifylline, and dipyridamole, the patient developed leg numbness and paresthesias.

Findings:

  • Nerve conduction studies revealed mononeuritis multiplex, a rare neurological complication of livedoid vasculopathy.
  • The patient's ulcerations resolved with medical management, but neurological symptoms persisted.

Implications:

  • This case underscores mononeuritis multiplex as a potential, albeit rare, complication of livedoid vasculopathy.
  • Highlights the importance of a multidisciplinary approach involving vascular specialists and neurologists for comprehensive patient care.
  • Suggests prompt recognition of neurological symptoms in LV patients is essential for timely intervention and management.