tetracycline and Livedo-Reticularis

Livedo vasculopathy (LV) is a chronic cutaneous disorder characterised by recurrent, painful ulceration ending in stellate scars. We have conducted a retrospective study of clinical features and treatment response of LV in 24 Chinese patients. LV occurred more frequently in women (male:female ratio  1:3). The peak age at onset of disease ranged from 14 to 20 years, younger than previously published data. 87.5% of the patients (21/24) showed significant summer exacerbation with ulcer formation. Out of 24 patients tested, 14 (58.3%) had positive antiphospholipid antibodies. Ten out of 14 patients (71.4%) were tested to be hypersensitive to multivalent insect antigens. Combinative anti-inflammatory therapy with steroids, tetracycline and Tripterygium glycosides plus antiplatelet/profibrinolytic drugs promoted quick healing of ulcer and reduce recurrence. The younger age of disease presentation and significant summer exacerbation are 2 novel clinical features observed in this study. These findings suggest that apart from procoagulation other risk factors may contribute significantly to the pathogenesis of LV. Although antiplatelet/profibrinolytic drugs are deemed as a first line therapy for LV, anti-inflammatory medications such as steroids, tetracycline and Tripterygium glycosides, from our experiences, are indispensable, especially for acute, ulcerative stage of disease.

Topics: Adolescent; Adult; Age Distribution; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antibodies, Antiphospholipid; Asian People; Biopsy; China; Female; Fibrinolytic Agents; Humans; Hypersensitivity; Insect Bites and Stings; Leg Ulcer; Livedo Reticularis; Male; Phytotherapy; Platelet Aggregation Inhibitors; Prednisone; Retrospective Studies; Seasons; Sex Distribution; Skin; Tetracycline; Tripterygium; Young Adult

Topics: Ammonium Chloride; Ammonium Compounds; Animals; Causalgia; Characidae; Ethyl Chloride; Humans; Livedo Reticularis; Neuralgia; Skin Diseases, Vascular; Tetracycline