A Case of Livedoid Vasculopathy with Rapid Response to Rivaroxaban: Case Report and Current Treatment Overview

Abstract

   Introduction: Livedoid vasculopathy (LV) is a rare chronic microvascular disorder characterized by persistent skin ulcers and atrophie blanche. It is often misdiagnosed as other conditions such as chronic venous insufficiency or necrotizing vasculitis.
   Case presentation: A 42-year-old woman presented with painful erythematous patches and superficial ulcers affecting both her lower limbs. She was initially treated for chronic venous insufficiency and later for nonspecific necrotizing vasculitis, but without improvement. Skin biopsy confirmed the diagnosis of livedoid vasculopathy. The patient did not respond to corticosteroids but showed rapid improvement after switching to oral rivaroxaban, with dry ulcers, reduced pain, and fading erythema observed after 7 days.
   Conclusion: This case highlights the essential role of skin biopsy in accurately diagnosing LV and the effectiveness of targeted anticoagulant therapy with rivaroxaban in achieving rapid symptom relief.             

DOI: 10.59715/pntjmp.5.2.23