A case report and literature review of livedoid vasculopathy in children

BackgroundLivedoid 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. T...

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Main Authors: Jing Qu, Zhihong Hao, Wang Junli, Shengyou Yu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1537133/full
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author Jing Qu
Zhihong Hao
Wang Junli
Shengyou Yu
Shengyou Yu
author_facet Jing Qu
Zhihong Hao
Wang Junli
Shengyou Yu
Shengyou Yu
author_sort Jing Qu
collection DOAJ
description BackgroundLivedoid 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 presentationWe report a case of a pediatric patient presenting with recurrent rashes and pain in both lower extremities. Physical examination revealed purpuric plaques with ulceration, scarring, and 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.ConclusionThis 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.
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spelling doaj-art-97c97b71cd1b48df9f58cc2b69c5e4fe2025-08-20T01:49:27ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-05-011310.3389/fped.2025.15371331537133A case report and literature review of livedoid vasculopathy in childrenJing Qu0Zhihong Hao1Wang Junli2Shengyou Yu3Shengyou Yu4Department of Pediatrics, Guangzhou First People’s Hospital, Guangdong Medical University, Zhanjiang, Guangdong, ChinaDepartment of Pediatrics, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, ChinaDepartment of Pediatrics, The Second Affiliated Hospital, South China University of Technology, Guangzhou, ChinaDepartment of Pediatrics, Guangzhou First People’s Hospital, Guangdong Medical University, Zhanjiang, Guangdong, ChinaDepartment of Pediatrics, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, ChinaBackgroundLivedoid 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 presentationWe report a case of a pediatric patient presenting with recurrent rashes and pain in both lower extremities. Physical examination revealed purpuric plaques with ulceration, scarring, and 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.ConclusionThis 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.https://www.frontiersin.org/articles/10.3389/fped.2025.1537133/fulllivedoid vasculopathy (LV)white atrophyrivaroxabancapillarieschildren
spellingShingle Jing Qu
Zhihong Hao
Wang Junli
Shengyou Yu
Shengyou Yu
A case report and literature review of livedoid vasculopathy in children
Frontiers in Pediatrics
livedoid vasculopathy (LV)
white atrophy
rivaroxaban
capillaries
children
title A case report and literature review of livedoid vasculopathy in children
title_full A case report and literature review of livedoid vasculopathy in children
title_fullStr A case report and literature review of livedoid vasculopathy in children
title_full_unstemmed A case report and literature review of livedoid vasculopathy in children
title_short A case report and literature review of livedoid vasculopathy in children
title_sort case report and literature review of livedoid vasculopathy in children
topic livedoid vasculopathy (LV)
white atrophy
rivaroxaban
capillaries
children
url https://www.frontiersin.org/articles/10.3389/fped.2025.1537133/full
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