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Correspondence | August 16, 2010

Livedoid Vasculopathy in a Pediatric Patient With Elevated Lipoprotein(a) Levels: Prompt Response to Continuous Low-Molecular-Weight Heparin

Tobias Goerge, MD; Carsten Weishaupt, MD; Dieter Metze, MD; Ulrike Nowak-Göttl, MD; Cord Sunderkötter, MD; Martin Steinhoff, MD, PhD; Stefan W. Schneider, MD

Arch Dermatol. 2010;146(8):918-935. doi:10.1001/archdermatol.2010.177.

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Callen JP Livedoid vasculopathy: what it is and how the patient should be evaluated and treated. Arch Dermatol 2006;142 (11) 1481- 1482
PubMed

Hairston BRDavis MDPittelkow MRAhmed I Livedoid vasculopathy: further evidence for procoagulant pathogenesis. Arch Dermatol 2006;142 (11) 1413- 1418
PubMed

Erqou SKaptoge SPerry PL et al. Emerging Risk Factors Collaboration, Lipoprotein(a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. JAMA 2009;302 (4) 412- 423
PubMed

Hairston BRDavis MDGibson LEDrage LA Treatment of livedoid vasculopathy with low-molecular-weight heparin: report of 2 cases. Arch Dermatol 2003;139 (8) 987- 990
PubMed

Papi MDidona BDe Pita O et al. Livedo vasculopathy vs small vessel cutaneous vasculitis: cytokine and platelet P-selectin studies. Arch Dermatol 1998;134 (4) 447- 452
PubMed

Anglés-Cano Ede la Pena Diaz ALoyau S Inhibition of fibrinolysis by lipoprotein(a). Ann N Y Acad Sci 2001;936261- 275
PubMed

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Figure 1.

Clinical photographs from the patient. A, Lightning-shaped livedo racemosa with partial necrosis and crusts before treatment. B, Residual postinflammatory hyperpigmentation and atrophic scarring but no ulceration after 4 months of treatment. Therapy was paused at this time.

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Figure 2.

Documentation of malleolar skin pain on a visual analog scale (VAS) ranging from 0 (no pain) to 10 (extreme pain). Arrows indicate changes in low-molecular-weight heparin therapy, 1 mg/kg/d. Observe the rapid regression of pain after treatment initiation and recurrence of pain after cessation of therapy.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

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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(8):918-935. doi:10.1001/archdermatol.2010.177.

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