rivaroxaban and Skin-Diseases--Vascular

Novel oral anticoagulant (NOAC) medications have revolutionized hematology and cardiology. Recently, NOACs have demonstrated additional promise in dermatology. Specifically, rivaroxaban, a direct factor Xa inhibitor NOAC, has been shown to be successful in the treatment of livedoid vasculopathy. Herein, we describe a patient with systemic lupus erythematosus who presented with painful cutaneous vasculopathy, demonstrated on biopsy with occlusive microvascular fibrin thrombi without evidence of concurrent vasculitis. Interestingly, imaging and laboratory studies did not show evidence of hypercoagulability, arterial disease, or embolic disease. The patient’s vasculopathy and pain progressed despite antiplatelet therapy, often considered first-line in cases of microvascular occlusive disease. However, with rivaroxaban therapy, the patient experienced complete regression of her painful lesions, thereby supporting a further role for NOACs in cutaneous vasculopathy treatment. J Drugs Dermatol. 2020;19(5) doi:10.36849/JDD.2020.4684.

Topics: Administration, Oral; Anticoagulants; Biopsy; Female; Foot; Humans; Lupus Erythematosus, Systemic; Middle Aged; Rivaroxaban; Skin; Skin Diseases, Vascular; Treatment Outcome

Topics: Adult; Factor Xa Inhibitors; Female; Humans; Leg Ulcer; Rivaroxaban; Skin; Skin Diseases, Vascular

Topics: Adult; Factor Xa Inhibitors; Female; Foot Ulcer; Humans; Leg Ulcer; Male; Rivaroxaban; Skin Diseases, Vascular; Treatment Outcome