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Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
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Long-Term Efficacy of Guideline-Followed Treatment in Patients with Livedoid Vasculopathy: A Single-Center Study

Carina Hillgruber1, Carolin Mitschang1, Maria Eveslage2

  • 1Department of Dermatology, University of Muenster, Muenster, Germany.

Advances in Wound Care
|November 20, 2025
PubMed

Insights

Long-term anticoagulation therapy, including rivaroxaban, effectively manages livedoid vasculopathy symptoms like pain and disease activity. This guideline-adherent treatment significantly improves patients

Area of Science:

  • Dermatology
  • Vascular Medicine
  • Pharmacology

Background:

  • Livedoid vasculopathy is a painful skin condition causing leg ulcerations and scarring (atrophie blanche) due to microcirculation thrombosis.
  • Current treatment options are limited, with no approved therapies, necessitating off-label use.
  • The German S1 guideline recommends anticoagulation as first-line therapy.

Purpose of the Study:

  • To evaluate the long-term efficacy of guideline-adherent anticoagulation treatment for livedoid vasculopathy.
  • To assess the impact of treatment on pain, disease activity, quality of life, and daily life.

Main Methods:

  • A single-center, follow-up study of 26 patients with livedoid vasculopathy.
  • Patients received treatment according to the German S1 guideline (anticoagulants like rivaroxaban).
  • Data collected via questionnaire on demographics, treatment, disease course, quality of life (DLQI), and daily impact.

Main Results:

  • Prolonged guideline-followed treatment effectively managed pain and disease activity in livedoid vasculopathy patients.
  • Patients reported high therapy satisfaction and sustained improvements in quality of life.
  • The study analyzed treatment efficacy over periods ranging from 3 to over 24 months.

Conclusions:

  • Guideline-adherent anticoagulation therapy, including rivaroxaban, is an effective long-term treatment for livedoid vasculopathy.
  • This approach leads to significant improvements in patient outcomes and quality of life.

Keywords:
atrophie blancheguidelineleg ulcerrivaroxabanwound healing

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