CASE REPORT article
Front. Pediatr.
Sec. Pediatric Rheumatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1537133
This article is part of the Research TopicVascular Injury in Systemic Diseases: Current Concepts and Future PerspectivesView all 9 articles
A Case Report and Literature Review of Livedoid Vasculopathy in Children
Provisionally accepted
- 1Guangzhou First People's Hospital, Guangzhou, China
- 2Guangdong Medical College, Zhanjiang, Guangdong Province, China
- 3South China University of Technology, Guangzhou, Guangdong Province, China
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Background: Livedoid vasculopathy (LV) is a rare, non-inflammatory, intradermal vascular obstructive skin disorder characterized by purpuric papules and plaques with capillary dilation. These lesions typically progress to crusted ulcers and ultimately result in fixed, white, atrophic stellate scars. The condition is marked by painful ulcers that heal slowly and have a tendency to recur. Case Presentation: This report details the case of a pediatric patient presenting with recurrent rashes and pain in both lower extremities. Physical examination revealed purpuric plaques with ulceration and scarring, as well as white atrophic healing features. Histopathological examination demonstrated intradermal thrombosis, vessel wall necrosis, and surrounding inflammatory cell infiltration with erythrocyte extravasation; periodic acid-Schiff (PAS) staining was positive. The clinical and pathological findings were consistent with a diagnosis of LV. The patient was treated with oral rivaroxaban. Conclusion: This case highlights the critical importance of early recognition and intervention in the management of LV. Clinicians should consider LV in the differential diagnosis when encountering patients with painful purpuric rashes. Improvement in pain following treatment with anticoagulants, such as rivaroxaban, may indirectly support the diagnosis. A skin biopsy is essential for definitive diagnosis.
Keywords: livedoid vasculopathy (LV), White atrophy, rivaroxaban, Capillaries, Children
Received: 30 Nov 2024; Accepted: 21 Apr 2025.
Copyright: © 2025 Qu, Hao, Junli and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: shengyou Yu, Guangzhou First People's Hospital, Guangzhou, China
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