Livedoid vasculopathy associated with HIV infection in two patients: A causal relationship?

Abstract

Livedoid vasculopathy (LV) is a rare cutaneous chronic disease characterized by recurrent, painful ulcerations of the legs and feet, following focal infiltrated purpura. Widespread LV may also occur (1). LV is commonly associated with livedo reticularis (2). Healing is slow, and leaves atrophie blanche, an irreversible scar (3). LV is characterized histologically by fibrin occlusion of dermal vessels without vasculitis (4). Although the pathophysiology is not fully understood, LV is classified either as idiopathic, or as a secondary form associated with hypercoagulable and/or autoimmune disorders, which justify anticoagulants or intravenous immunoglobulins (5–7). We describe here 2 patients who developed LV associated with human immunodeficiency virus (HIV)-1 infection and severe nephropathy; an association that has not been reported previously.