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Correspondence |

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 Link to Article[[XSLOpenURL/10.1001/archderm.142.11.1481]]
Hairston  BRDavis  MDPittelkow  MRAhmed  I Livedoid vasculopathy: further evidence for procoagulant pathogenesis. Arch Dermatol 2006;142 (11) 1413- 1418
PubMed Link to Article[[XSLOpenURL/10.1001/archderm.142.11.1413]]
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 Link to Article[[XSLOpenURL/10.1001/jama.2009.1063]]
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 Link to Article[[XSLOpenURL/10.1001/archderm.139.8.987]]
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 Link to Article[[XSLOpenURL/10.1001/archderm.134.4.447]]
Anglés-Cano  Ede la Pena Diaz  ALoyau  S Inhibition of fibrinolysis by lipoprotein(a). Ann N Y Acad Sci 2001;936261- 275
PubMed Link to Article[[XSLOpenURL/10.1111/(ISSN)1749-6632]]
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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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