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Intravenous immunoglobulins in difficult‐to‐treat ulcerated livedoid vasculopathy: five cases and a literature review
Author(s) -
Bounfour Touda,
Bouaziz JeanDavid,
Bézier Maud,
Petit Antoine,
Viguier Manuelle,
Rybojad Michel,
Bagot Martine
Publication year - 2013
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2012.05826.x
Subject(s) - medicine , refractory (planetary science) , intravenous immunoglobulins , placebo , surgery , visual analogue scale , antibody , dermatology , pathology , physics , alternative medicine , astrobiology , immunology
Background Livedoid vasculopathy ( LV ) is a thrombotic vasculopathy of the skin of unknown origin. No treatment has been validated in this indication, but case reports suggest the successful use of intravenous immunoglobulins (IVIG) in LV . Methods Outcomes in five patients treated with IVIG for treatment‐resistant ulcerated LV were retrospectively analyzed. Results Treatment with IVIG induced complete remission (based on clinical evaluation and a pain‐related visual analog scale) in four patients but was ineffective in one patient. Three patients relapsed; the median time to relapse was 10.7 months. Re‐treatment with IVIG in these three patients was successful. Conclusions These cases confirm previous reports that IVIG seems to be a rapid, effective, and safe treatment for patients with idiopathic refractory ulcerated LV . However, a placebo‐controlled study is mandatory to confirm these results.