Abstract | BACKGROUND:
Livedoid vasculitis (LV) usually presents with painful, slowly healing ulcerations of the lower limbs. The precise pathophysiology of this relatively rare disease remains obscure. Therapeutic strategies usually include rheologic, anti-inflammatory, or immunosuppressive agents. However, no continuing benefit has been reported in any of these modalities. Recently, encouraging case reports about the successful use of intravenous immunoglobulin ( IVIg) in LV have been published. METHODS: We initiated an open single center trial to investigate the efficacy and safety of IVIg in LV. Nine patients with LV, 7 of whom were refractory to other treatment modalities, were included. Therapy with IVIg at a dose of 0.5 g/kg body weight per day over 2 or 3 consecutive days was performed monthly. Skin involvement before and after therapy was assessed by means of a clinical score. RESULTS: In all patients, significant regression of skin lesions was observed after therapy resulting in a decrease of the clinical score (including differential semiquantitative assessment of erythema, ulceration, and pain) from 6.5 +/- 1.7 at the beginning to 1.3 +/- 1.2 after therapy (P <.001). IVIg was well tolerated and therapy was finished in all patients. CONCLUSION: In all patients clinical evaluation revealed a marked improvement of erythema, pain, and healing of areas of active ulceration. Although this was an open non-controlled study, we propose that IVIg is a promising therapeutic option in LV refractory to other treatment modalities.
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Authors | Alexander Kreuter, Thilo Gambichler, Frank Breuckmann, Falk G Bechara, Sebastian Rotterdam, Markus Stücker, Peter Altmeyer |
Journal | Journal of the American Academy of Dermatology
(J Am Acad Dermatol)
Vol. 51
Issue 4
Pg. 574-9
(Oct 2004)
ISSN: 1097-6787 [Electronic] United States |
PMID | 15389193
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Immunoglobulins, Intravenous
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Topics |
- Adult
- Female
- Humans
- Immunoglobulins, Intravenous
(therapeutic use)
- Male
- Middle Aged
- Smoking Prevention
- Treatment Outcome
- Vasculitis
(classification, drug therapy, etiology)
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