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DOI: 10.1055/s-0043-104353
Rivaroxaban als effektive Therapieoption der Livedovaskulopathie
Rivaroxaban as an Effective Treatment of Livedoid VasculopathyPublikationsverlauf
Publikationsdatum:
15. Mai 2017 (online)

Zusammenfassung
Die Livedovaskulopathie ist eine seltene Vaskulopathie mit thrombembolischen Verschlüssen kleiner und mittlerer Hautgefäße. Therapieversuche mit verschiedenen Immunsupressiva zeigten wenig Ansprechen und resultierten in therapierefraktären Verläufen. Vor einigen Jahren wurde die deutlich bessere Wirksamkeit verschiedener Antikoagulantien beschrieben. Wir berichten über einen 30-jährigen Patienten, welcher unter der Therapie mit Rivaroxaban eine zügige Besserung des Krankheitsbildes erfahren hat.
Abstract
The livedoid vasculopathy is a rare disease caused by thromboembolic occlusion of small and medium vessels in the superficial dermal plexus. Immunosuppressive treatment was often ineffective and resulted in a refractory disease cause. The efficiency of anticoagulants in the treatment of the disease was described a couple of years ago. Here, we report successful treatment with rivaroxaban and fast achievement of remission in a 30-year-old patient with livedoid vasculopathy.
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Literatur
- 1 Kerk N, Drabik A, Luger T. et al. Rivaroxaban prevents painful cutaneous infarctions in livedoid vasculopathy. British Journal of Dermatology 2013; 168: 898-899
- 2 Altmeyer P. Livedovaskulopathie. Enzyklopädie der Dermatologie, Venerologie, Allergologie, Umweltmedizin [WWW Document], n.d.. http://www.enzyklopaedie-dermatologie.de/artikel?id=2400 (accessed 1.26.17)
- 3 Lee SS, Ang P, Tan SH. Clinical profile and treatment outcome of livedoid vasculitis: a case series. Ann Acad Med Singap 2003; 32: 835-839
- 4 Schanz S, Ulmer A, Fierlbeck G. Intravenous immunoglobulin in livedo vasculitis: A new treatment option?. Journal of the American Academy of Dermatology 2003; 49: 555-556
- 5 Goerge T, Weishaupt C, Metze D. et al. Livedoid Vasculopathy in a Pediatric Patient With Elevated Lipoprotein(a) Levels: Prompt Response to Continuous Low-Molecular-Weight Heparin. Arch Dermatol 2010; 146: 918-935
- 6 Weishaupt C, Strölin A, Kahle B. et al. Anticoagulation with rivaroxaban for livedoid vasculopathy (RILIVA): a multicentre, single-arm, open-label, phase 2a, proof-of-concept trial. Lancet Haematol 2016; 3: e72-79
- 7 Hairston BR, Davis MDP, Pittelkow MR. et al. Livedoid Vasculopathy: Further Evidence for Procoagulant Pathogenesis. Arch Dermatol 2006; 142: 1413-1418
- 8 Calamia KT, Balabanova M, Perniciaro C. et al. Livedo (livedoid) vasculitis and the factor V Leiden mutation: additional evidence for abnormal coagulation. J Am Acad Dermatol 2002; 46: 133-137
- 9 Boyvat A, Kundakçi N, Babikir MO. et al. Livedoid vasculopathy associated with heterozygous protein C deficiency. Br J Dermatol 2000; 143: 840-842
- 10 Acland KM, Darvay A, Wakelin SH. et al. Livedoid vasculitis: a manifestation of the antiphospholipid syndrome?. Br J Dermatol 1999; 140: 131-135
- 11 Gibson GE, Li H, Pittelkow MR. Homocysteinemia and livedoid vasculitis. J Am Acad Dermatol 1999; 40: 279-281
- 12 Pizzo SV, Murray JC, Gonias SL. Atrophie blanche. A disorder associated with defective release of tissue plasminogen activator. Arch Pathol Lab Med 1986; 110: 517-519
- 13 Papi M, Didona B, De Pità O. et al. Livedo vasculopathy vs small vessel cutaneous vasculitis: cytokine and platelet P-selectin studies. Arch Dermatol 1998; 134: 447-452
- 14 Hairston BR, Davis MDP, Gibson LE. et al. Treatment of Livedoid Vasculopathy With Low-Molecular-Weight Heparin: Report of 2 Cases. Arch Dermatol 2003; 139: 987-990
- 15 Winchester D, Drage L, Davis M. Response of livedoid vasculopathy to rivaroxaban. Br J Dermatol 2015; 172: 1148-1150
- 16 Ellinghaus P, Perzborn E, Hauenschild P. et al. Expression of pro-inflammatory genes in human endothelial cells: Comparison of rivaroxaban and dabigatran. Thromb Res 2016; 142: 44-51