Livedoid vasculopathy and its association with factor V Leiden mutation

Yong AA, Tan AW, Giam YC, Tang MB
Correspondence: Dr Angeline Anning Yong, angelpeace109@hotmail.com

ABSTRACT
Livedoid vasculopathy is a rare chronic relapsing disorder characterised by recurrent painful thrombotic and vasculitic ulcers on the legs. We present the cases of two Indian women with livedoid vasculopathy that were found to be associated with an underlying factor V Leiden heterozygous mutation. There were no other thrombotic manifestations, and livedoid vasculopathy was the sole presenting feature of the factor V Leiden mutation, although this could also be coincidental. Initial treatment with high-dose immunosuppressive therapy was suboptimal, and the addition of pentoxifylline and antiplatelet therapy was crucial in achieving disease control and remission. These cases highlight the possible association with an underlying prothrombotic disorder, such as factor V Leiden mutation, in patients with livedoid vasculopathy. Although this association is relatively uncommon, it is more relevant to Indian patients, as the presence of factor V Leiden mutation is highest in this ethnicity as compared to the local Malay and Chinese populations.

Keywords: antiplatelet therapy, atrophie blanche, factor V Leiden mutation, livedoid vasculopathy, vasculitic ulcers
Singapore Med J 2012; 53(12): e258–e260