Livedo vasculopathy is a disease that manifests itself in disorders of blood coagulation in small, dermal blood capillaries. Livedo vasculopathy causes the affected tissue to die, which is associated with considerable pain. In addition, necrosis forms on the skin affected by livedo vasculopathy. The pathological changes leave irreversible scars on the skin.
What is livedo vasculopathy?
In principle, livedo vasculopathy is very rare. Synonymous disease terms are, for example, atrophy blanche or livedo vasculitis. Livedo vasculopathy is primarily caused by coagulation disorders in the skin.
According to Bittranslators, livedo vasculopathy is a chronic disease of the blood vessels located inside the skin. Tiny capillaries in the upper areas of the skin are affected. Occlusions of the blood vessels develop as a result of livedo vasculopathy. As a result, the upper skin regions are not supplied with sufficient blood.
As a result, the affected skin tissue perishes, which is referred to in medical jargon as a skin infarction. Livedo vasculopathy results in open skin wounds that are associated with intense pain. The resulting ulcers heal only with difficulty. In the majority of cases, livedo vasculopathy is diagnosed relatively late. In principle, however, the previous treatment options are comparatively successful.
Causes
The mechanism of development of livedo vasculopathy has been clarified for the most part, but not all the underlying causes have been researched. In the area of the skin there are numerous tiny blood vessels that supply the skin with blood, oxygen and nutrients. Due to currently unknown factors, the tendency of the blood to coagulate increases in the corresponding areas.
This phenomenon is referred to in medicine as increased thrombophilia. The upper skin regions are only supplied by a small number of blood vessels. The occlusion of vessels therefore quickly results in an undersupply of the skin areas, which subsequently die (medical term necrosis ). It is characteristic of livedo vasculopathy that the pathological developments mainly take place in the warm months of the year.
Some researchers suspect that a reduced concentration of water in human blood increases the tendency to clot. Because the blood viscosity is increased at high air temperatures. In addition, livedo vasculopathy occurs about three times more frequently in female patients than in male patients. The exact reasons for this high gender difference have not yet been researched.
Symptoms, Ailments & Signs
The livedo vasculopathy is mainly characterized by a characteristic combination of three main complaints: First, the affected patients show so-called livedo racemosa markings. These already indicate that the respective person has a particular susceptibility to the development of livedo vasculopathy.
Another important sign of livedo vasculopathy is ulceration, which manifests itself as an open skin wound. This is an acute symptom of livedo vasculopathy. Finally, the diseased skin area develops into a so-called atrophie blanche, which describes the scar on the skin. The scar as a remnant of the acute phase of livedo vasculopathy always remains visible on the skin.
Diagnosis & disease progression
A diagnosis of livedo vasculopathy is usually based on the clinical signs of the disease. Patients with suspected livedo vasculopathy consult their dermatologist. Anamnesis is mandatory before the clinical examinations.
This is followed by an initial visual examination, in which the treating doctor examines the affected area more closely, using special magnifying glasses, for example. Tissue samples that are analyzed in the laboratory are also possible. A relatively reliable diagnosis of livedo vasculopathy is possible on the basis of the patient’s description of the symptoms present and the clinical picture.
Complications
As a rule, patients suffer from very severe pain as a result of livedo vasculopathy. This pain can be stabbing and burning and significantly reduces the patient’s quality of life. The entire everyday life of the person affected is also significantly restricted and reduced by livedo vasculopathy, so that normal activities are usually no longer possible for the person affected.
It is not uncommon for this disease to leave behind large scars, which are usually irreversible and therefore do not heal. The scars cause the patient to have reduced aesthetics and thus possibly to inferiority complexes or reduced self-esteem. Not infrequently, the pain can also occur at night and lead to sleep disorders or depression.
Treatment of livedo vasculopathy can be done with the help of injections and is not associated with any special complications. In most cases, these injections control and treat the symptoms fairly well, allowing the person to lead a normal life again. However, this cannot prevent further outbreaks of this disease, so that the affected person may need to be treated again. However, life expectancy is not reduced or limited by this disease.
When should you go to the doctor?
If open wounds or other signs of illness appear without a cause, professional advice is required. A dermatologist can determine whether the trigger is livedo vasculopathy. People who have a suspicion should seek early advice from their family doctor, who can make an initial diagnosis and then refer the patient to a specialist if necessary. At the latest when there are subsequent symptoms such as inflammation or scarring of the skin, the ailment must be taken to the dermatologist.
Women are significantly more likely to develop livedo vasculopathy. The disease also occurs mainly in the summer months. If the symptoms described occur and possibly also the risk factors mentioned are present, livedo vasculopathy can be assumed. Then a doctor’s appointment must be made so that the disease can be diagnosed and treated quickly. If this happens early, permanent damage can usually be avoided. The right doctor is the general practitioner or a dermatologist. If the skin changes represent a psychological burden, a therapist consultation is recommended.
Treatment & Therapy
The treatment options for livedo vasculopathy are comparatively well developed. Basically, the focus of the technical treatment measures is to reduce the tendency of the blood to coagulate. For this purpose, drug therapy is usually used first.
The patient usually receives medicinal substances that are also used to prevent thrombosis. The doctor therefore often prescribes heparins for people suffering from livedo vasculopathy, which are usually administered in the form of injections. The use of other drugs to treat livedovasculopathy is under investigation in numerous research studies.
In the context of such a study, the active substance rivaroxaban showed good effectiveness. Treatment with this drug requires sensitive coordination between the patient and the doctor regarding the dosage and the duration of administration. The risk of potential bleeding should be carefully considered.
The prognosis of livedo vasculopathy is comparatively positive. Good control of livedo vasculopathy is possible if appropriate technical treatment measures are taken. In this context, the administration of anticoagulants plays an essential role. As a result, the pain usually decreases for the affected patients.
However, there is a risk that livedo vasculopathy will break out again and again. For this reason, long-term medical care of the sick person in a specialized center makes sense.
Outlook & Forecast
If the person concerned seeks medical treatment, they have a good chance of alleviating the symptoms. Long-term therapy is necessary because the blood coagulation disorder is not part of any temporary health impairment. In most cases, therefore, there is no recovery, but freedom from symptoms as soon as medication is taken at regular intervals.
If left untreated, livedo vasculopathy can lead to numerous complications. In addition to impairments in everyday life, secondary diseases develop. Some of them lead to a life-threatening condition. For a better assessment of the situation and to avoid health risks, treatment should be initiated as soon as the first irregularities and complaints appear.
The drugs help the organism in the process of blood coagulation and bring it into the necessary balance. To avoid side effects and the correct dosage of the prescribed medicines, close cooperation with the doctor treating you is necessary. This improves overall health and quality of life.
Some patients may have periods when they are symptom-free. In these, no medication must be given temporarily. Nevertheless, regular check-ups and medical tests are necessary, as the symptoms can recur at any time. The more attentively the person concerned deals with the signals of his organism, the better the health development.
Prevention
There is currently little reliable knowledge of effective measures to prevent livedo vasculopathy. As with many other diseases, however, it is advisable for risk groups to stop smoking. Because nicotine constricts the blood vessels and for this reason possibly increases the tendency to blood clotting.
Aftercare
Follow-up care for a blood clotting disorder takes the form of preventive measures and medical checks. The type of aftercare also depends on the nature of the blood clotting disorder. In almost every case it is necessary to have the flow properties of the blood checked regularly and to keep an overview of the coagulation factors.
For people with a strong tendency to clot, aftercare consists primarily of regular blood vessel checks. Since thrombosis occurs frequently, it must be detected early. Accordingly, a prophylactic administration of blood thinners can be useful. In stressful situations that involve little exercise, such as long-haul flights, for example, the administration of blood thinners is recommended.
Follow-up care also includes clarifying any abnormalities (e.g. discoloration of the skin, blood in the stool or urine) and avoiding injuries as a matter of urgency. Drugs, the administration of hormones or donor factors can be necessary for lifelong prophylaxis. If internal bleeding has caused tissue damage, follow-up care consists of appropriate therapy.
If the muscles or bones are affected, this means that physical therapy is used. Endurance sports are suitable, but not contact sports. In the case of damage to the organs, however, aftercare must be based on the damage in question.
You can do that yourself
It is not possible to treat livedo vasculopathy through self-help measures. Those affected are therefore dependent on medical treatment to prevent complications and other symptoms.
As a rule, the treatment of livedo vasculopathy is carried out with the help of drugs that reduce blood clotting. Patients should ensure that they take these medications regularly. Various interactions with other medications must also be taken into account, otherwise the effect may be reduced. There is usually no further treatment. The sufferer should protect his body to avoid bleeding and injury.
As a rule, the consumption of nicotine also has a negative effect on the course of the disease and should therefore be stopped in any case. If quitting smoking is not a voluntary decision, friends and family can also help. In serious cases, a withdrawal can also be carried out. Furthermore, contact with other people affected by livedo vasculopathy is often worthwhile, as this can lead to an exchange of information.
