Article : Rivaroxaban: Another Treatment for Livedoid Vasculopathy?

In a small case series, this oral anticoagulant reduced the number of new ulcerations and decreased pain.

Livedoid vasculopathy is a chronic, often painful eruption of recurrent, small ulcerations, usually affecting the lower legs. This condition has been linked to a variety of coagulopathies, but even in the absence of an identifiable genetic clotting abnormality, the disease is characterized by observation of thrombotic plugging of the small vessels in skin biopsy samples. Therapy is aimed at lowering thrombophilic potential in affected patients. Rivaroxaban is a newly approved oral anticoagulant used for the prevention of thromboembolism. It blocks factor Xa and causes an irreversible inhibition of thrombin formation and the development of thrombi. It has no effect on platelets.


These authors report their observation of three patients treated with rivaroxaban for livedoid vasculopathy. All three had elevated lipoprotein(a), a marker of thromboembolism and potential cardiovascular disease, but were otherwise healthy. Patients received 10 mg of rivaroxaban daily, and their pain levels and the frequency of new ulcerations were measured. Within 1 month, pain levels neared 0, and by 3 months, few new ulcerations were occurring.

CITATION(S):

Kerk N et al. Rivaroxaban prevents painful cutaneous infarctions in livedoid vasculopathy. Br J Dermatol 2012 Oct 27; [e-pub ahead of print].

BACK