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Livedoid vasculopathy and hypercoagulability in a patient with primary Sjögren's syndrome.

dc.contributor.authorCardoso, R
dc.contributor.authorGonçalo, Margarida
dc.contributor.authorTellechea, O
dc.contributor.authorMaia, R
dc.contributor.authorBorges, C
dc.contributor.authorPereira da Silva, JA
dc.contributor.authorFigueiredo, A
dc.date.accessioned2009-02-20T17:33:24Z
dc.date.available2009-02-20T17:33:24Z
dc.date.issued2007
dc.description.abstractBACKGROUND: A 31-year-old woman presented with a 5-year history of painful ulcerations, palpable purpura, porcelain-white atrophic scars of the malleolar region and dorsal aspect of the feet, livedo reticularis on the limbs, arthralgia, xerophthalmia, and xerostomia. METHODS: Skin biopsy revealed vessel wall hyalinization and thrombosis of the microvasculature with a very scarce dermal inflammatory infiltrate. Biopsy of the oral mucosa showed mononuclear infiltration of an intralobular duct of a salivary gland. RESULTS: Laboratory studies, including autoantibodies and inflammation markers, were normal, except for a positive rheumatoid factor. Coagulation screening revealed C677T methylenetetrahydrofolate reductase (MTHFR) mutation, with a normal serum homocysteine. The patient was treated with oral methylprednisolone (32 mg/day with progressive reduction) and enoxaparin (20 mg/day subcutaneously), with complete ulcer healing within 4 months. CONCLUSION: Livedoid vasculitis or vasculopathy has not been referred to previously in association with Sjögren's syndrome, but may be associated with other autoimmune disorders and anomalies of coagulation, namely factor V Leiden mutation, protein C deficiency, and MTHFR mutation, associated or not with hyperhomocysteinemia, a condition that seems to confer an increased risk of recurrent arterial and venous thrombosis. We stress the importance of anticoagulant therapy for ulcer healing and for the prevention of other thrombotic events.en
dc.identifier.citationInt J Dermatol. 2007 Apr;46(4):431-4.en
dc.identifier.urihttp://hdl.handle.net/10400.4/475
dc.language.isoengen
dc.rights.uriopenAccessen
dc.subjectSíndrome de Sjögrenen
dc.subjectVasculitesen
dc.subjectTrombofiliaen
dc.titleLivedoid vasculopathy and hypercoagulability in a patient with primary Sjögren's syndrome.en
dc.typejournal article
dspace.entity.typePublication
rcaap.typearticleen

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