Livedo vasculitis Ì1 á Yoko HOSOI, M. D., Jun-ichi KITAJIMA, M. D. and Toshio HAMADA, M. D.
I. Idiopathic livedo reticularis summer or winter ulcerations livedo vasculitis II. Symptomatic livedo reticularis A. Collagen diseases PN, LE, dermatomy ositis, RA, rheumatic F. Intravascular occlusion pancreatitis, arterial emboli dermite livedoide of Nicolau fever B. Chronic infectious diseases tuberculosis, secondary syphilis C, Neoplastic diseases: mycosis fungoides D. Blood disease: thrombocythemia E. Cold-induced vascular disorders cryoglobulinemia, acrocyanosis, pernio G. Other vascular disorders arteriosclerosis, congenital livedo reticularis (modified from Short) 5)
1. Champion, R. H.: Livedo reticularis, a review, Br. J. Dermatol., 77: 167-179, 1965. 2. Feldaker, M., Hines, E. A., Jr. and Kierland, R. R.: Livedo reticularis with summer ulcerations, Arch. Dermatol., 72: 31-42, 1955. 3. Bard, J. W. and Winkelmann, R. K.: Livedo vasculitis: segmental hyalinizing vasculitis of the dermis, Arch. Dermatol., 96: 489-499, 1967. 4. Winkelmann, R.K.: Livedoid vasculitis (segmental hyalinizing vasculitis), Jap. J. Dermatol., Ser. B., 82: 84-89, 1972. 5. Short, J. M.: Livedo reticularis, Clinical Dermatology (Demis, D. J., Dobson, R. L. and McGuire, J., Eds), Vol. 2, Section 7-38, Harper and Row Philiadelphe, 1980, 1-4
ologic study, Arch. Dermatol., 111: 188-193, 1975. 12. Stevanovic, D. V.: Atrophie blanche (a sign of dermal blood occlusion), Arch. Dermatol, 109: 858-862, 1974. 9. Milian, G.: Les atrophies cutanees syphilitiques, Bull. Soc. Fr. Dermatol. Syphiligr., 36: 865-871, 1929. 10. Gray, H. R., Graham, J. H., Johnson, W. and Burgoon, C.F.: Atrophie blanche: periodic painful ulcers of lower extremities, Arch. Dermatol., 93: 187-193, 1966. 11. Schroeter, A. L., Diaz-Perez, J. L., Winkelmann, R. K. and Jordon, R. E.: Livedo vasculitis (the vasculitis of atrophie blanche): immunohistopath- 13. Stiefler, R. E. and Bergfeld, W. F.: Atrophie blanche, review, Int. J. Dermatol., 21: 1-7, 1982. 14 ³ ߎ, žš m F,ŒÃ ì O, c M M:Livedo reticularis with summer ulcerations, ç Õ, 21: 25-30, º 54. 15. Su, W. P. D. anp Winkelmann, R. K.: Livedoid vasculitis, Vasculitis (Wolff, K. and Winkelmann, R. K., Eds.), Lloyd-Luke, London, 1980, 297-306. Livedo Vasculitis Yoko Hosoi, Jun-ichi Kitajima and Toshio Hamada Department of Dermatology, Osaka City University Medical School A case of livedo vasculitis is reported in a 20-year-old woman. She had noticed reticulated erythema on the almost whole areas of extremities about eight years ago. One month ago atrophie blanche-like lesion had appeared on the inner aspect of right lower leg. Subsequently, the lesion had developed into ulcer. Atrophie blanche-like lesions were also found on the internal and external malleoli of right lower leg. Laboratory data did not show any abnormalities. The histopathological examinations of atrophie blanche-like lesion showed atrophic epidermis, endothelial proliferation in the vessels of dermis, thickening of their walls and fibrinoid degeneration and mild lymphocytic infiltration around the vessels. In direct immunofluorescence, deposition of C3, IgM and fibrinogen was revealed at the vascular walls. She was treated with DDS. After the ulcer healed, the administration of DDS was stopped. No ulcer has been developed for one year after the cessation of the treatment.