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Livedoid vasculopathy in hemoglobinopathy-associated chronic leg ulcers
Harish Eswaran1, Samuel Wilson2, Jane Little2
1Division of Hematology, Department of Medicine, UNC Chapel Hill School of Medicine, Chapel Hill, NC, United States of America. harish.eswaran@unchealth.unc.edu.
Livedoid vasculopathy (LV) is rarely a cause of chronic leg ulcers in hemoglobin disorders. This study found LV in only two patients, and anticoagulation offered no benefit for their leg ulceration.
Area of Science:
- Hematology
- Dermatology
- Vascular Medicine
Background:
- Chronic leg ulceration is a common complication of hemoglobinopathies.
- Livedoid vasculopathy (LV), a thrombotic disorder, has been suggested as a cause of these ulcers.
- The prevalence and effectiveness of anticoagulation for LV in this context are not well understood.
Purpose of the Study:
- To investigate the prevalence and outcomes of secondary workup for livedoid vasculopathy (LV) in patients with hemoglobinopathy-associated chronic leg ulcers.
- To determine the relevance of LV as a cause of chronic leg ulceration in hemoglobin disorders.
Main Methods:
- Retrospective analysis of 108 patients with hemoglobinopathy-associated chronic leg ulcers.
- Review of skin biopsy findings and treatment responses.
Main Results:
- Only 15% of patients underwent skin biopsy, with 97% showing non-specific findings.
- Livedoid vasculopathy (LV) was diagnosed in two patients (approximately 1.85%).
- Neither patient with LV responded to anticoagulation therapy.
Conclusions:
- Livedoid vasculopathy (LV) is an uncommon cause of chronic leg ulceration in patients with hemoglobin gene disorders.
- The efficacy of anticoagulation for LV in the setting of hemoglobinopathies remains uncertain and likely limited.
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