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Livedoid vasculopathy

Mark DP Davis, MD
Section Editors
Gene G Hunder, MD
Jeffrey Callen, MD, FACP, FAAD
Deputy Editors
Abena O Ofori, MD
Monica Ramirez Curtis, MD, MPH


Livedoid vasculopathy is a chronic, recurrent, painful skin disorder that involves the distal lower extremities and feet. The disorder is a thrombotic condition associated with the formation of clots within the lumina of medium-sized arterioles and with hyalinizing changes within the subintimal region of involved vessels.

Livedoid vasculopathy can occur by itself or in the setting of a variety of systemic disorders, such as systemic lupus erythematosus and antiphospholipid syndrome. The disorder has also been linked to a growing list of hypercoagulable states. Livedoid vasculopathy is often misdiagnosed as either chronic venous insufficiency or some form of systemic or cutaneous vasculitis.

The clinical manifestations, diagnosis, and treatment of livedoid vasculopathy are presented here. Chronic venous insufficiency and small- and medium-vessel vasculitis of the skin are discussed elsewhere. (See "Clinical manifestations of lower extremity chronic venous disease" and "Diagnostic evaluation of chronic venous insufficiency" and "Overview of cutaneous small vessel vasculitis" and "Clinical manifestations and diagnosis of polyarteritis nodosa in adults".)


The literature related to livedoid vasculopathy is highly problematic with regard to nomenclature [1]. There are three major sources of confusion:

Atrophie blanche, the descriptive term for the major cutaneous manifestations of livedoid vasculopathy, is often employed interchangeably with the more appropriate names for the disease entity (livedoid vasculopathy or segmental hyalinizing vasculopathy) [2]. (See 'Atrophie blanche' below.)


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Literature review current through: Jul 2017. | This topic last updated: Oct 14, 2016.
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