Livedoid vasculopathy and skin ulcers in patients with inherited thrombophilia.

Livedoid vasculopathy is a chronic recurrent disease usually affecting the skin of the lower extremities, and characterized by painful ulcers that may heal with hyperpigmentation and atrophic scars. It mostly represents an idiopathic disorder occasionally associated with systemic diseases. The pathogenesis of livedoid vasculopathy is still unclear but recent evidence suggests that it is primarily a non-inflammatory occlusive thrombotic disease. Recent reports have shown that hypercoagulability due to inherited thrombophilia may have a role in the development of cutaneous small vessel thrombosis and livedoid vasculopathy. We describe two young males affected with livedoid vasculopathy and large skin ulcers in the lower extremities associated with factor V Leiden and hyperhomocysteinemia secondary to methylenetetrahydrofolate reductase deficiency, respectively.