Intravenous immunoglobulin in resistant livedoid vasculopathy: Analysis of a case series

Özden, Müge Güler; Özdemir, Hilal; Şentürk, Nilgün

doi:10.1111/dth.13229

Cited by 13 publications

(27 citation statements)

References 10 publications

(12 reference statements)

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“… 10 Further retrospective case series such as Bounfour et al including 5 patients and Ozden et al including 9 patients with IVIG 2 g/kg bodyweight over a period of 3 days also reported good therapeutic response regarding pain and ulceration. 13 , 18 …”

Section: Discussionmentioning

confidence: 99%

“…4,[7][8][9] In addition, a response to IVIG was shown in smaller collectives. 10,12,18 LV is often associated with extreme pain and severe restrictions in patients' private and professional lives. This study shows a significant improvement in the symptoms of LV in terms of pain, ulceration and restrictions in everyday life under therapy with IVIG.…”

Section: Discussionmentioning

confidence: 99%

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Intravenous Immunoglobulin Therapy in Livedoid Vasculopathy: Retrospective Observation of Clinical Outcome and Patient’s Activity Level

et al. 2021

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Background Livedoid vasculopathy (LV) is a rare disease characterized by livedo racemosa, atrophie blanche, ulcerations, and severe pain. Low molecular weight heparins and rivaroxaban can be used in LV-patients. In addition, intravenous immunoglobulins (IVIG) have been described as treatment-option. Objectives Objective was to investigate the therapeutic effect of IVIG on ulcer, pain and restrictions in daily life. Methods Thirty-two LV-patients who received IVIG at the Department of Dermatology Tübingen between 01/2014 and 06/2019 were identified. Twenty-five of these patients were available for further follow up and were included in the study. Patients were interviewed using a questionnaire focusing on the course of the disease, symptoms, and subjective response to IVIG-treatment. Results Twenty-five patients were included in the study (mean follow up: 28.9 months). Patients received an average of 6.8 cycles (range 1-45) of IVIG during the observed period. Significant improvements were seen regarding skin findings, pain, and limitation of daily activities. Complete remission of symptoms was observed in 68% of patients. Good tolerability of IVIG was shown in 92%. Conclusions A good therapy response regarding ulceration, pain, and daily life restrictions with good tolerability was demonstrated for IVIG (2 g/kg bodyweight over 5 days).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intravenous Immunoglobulin Therapy in Livedoid Vasculopathy: Retrospective Observation of Clinical Outcome and Patient’s Activity Level

et al. 2021

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“…The beneficial effects of intravenous immunoglobulins (IVIG) for LV have been reported. [4][5][6][7][8] However, no standard protocol of the regimen with IVIG for LV has been established, and its superiority over other medications especially in severe cases intractable to conventional medications has not been confirmed. Here, we report a case of severe LV refractory to intense immunosuppressive and anti-thrombotic agents, in which only two cycles of IVIG resulted in remission for 7 years.…”

Section: Long-term Remission Of Severe Livedoid Vasculopathy Treated With a Short Course Of Intravenous Immunoglobulinmentioning

confidence: 99%

“…In previous reports, IVIG was administered at a dose of 1-2 g/kg and repeated for several to more than 10 cycles regularly at 4-week intervals. [5][6][7][8] Most patients achieved dramatic improvement or remission in skin manifestations after the first to the third cycle.…”

Section: Long-term Remission Of Severe Livedoid Vasculopathy Treated With a Short Course Of Intravenous Immunoglobulinmentioning

confidence: 99%

Long‐term remission of severe livedoid vasculopathy treated with a short course of intravenous immunoglobulin

Takahagi

Tanaka

Morioke

et al. 2021

J Cutaneous Imm & Allergy

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“…Then, the viruses spread through the bloodstream and mainly in the lungs, gastrointestinal tract, and heart, presumably concentrated in the tissues expressing ACE2, the receptor of SARS‐CoV‐2. This phase occurs around 7‐14 after the onset of the symptoms when the virus starts a second attack, which is also the main cause of the aggravation of symptoms 93 . At this time, pulmonary lesions became worse, and chest CT scans show imaging changes consistent with COVID‐19 94 .…”

Section: Skin Conditions Related To Hypercoagulability That Show Histmentioning

confidence: 99%

Lessons from dermatology about inflammatory responses in Covid‐19

Criado

Pagliari

Carneiro

et al. 2020

Reviews in Medical Virology

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Summary The SARS‐Cov‐2 is a single‐stranded RNA virus composed of 16 non‐structural proteins (NSP 1‐16) with specific roles in the replication of coronaviruses. NSP3 has the property to block host innate immune response and to promote cytokine expression. NSP5 can inhibit interferon (IFN) signalling and NSP16 prevents MAD5 recognition, depressing the innate immunity. Dendritic cells, monocytes, and macrophages are the first cell lineage against viruses' infections. The IFN type I is the danger signal for the human body during this clinical setting. Protective immune responses to viral infection are initiated by innate immune sensors that survey extracellular and intracellular space for foreign nucleic acids. In Covid‐19 the pathogenesis is not yet fully understood, but viral and host factors seem to play a key role. Important points in severe Covid‐19 are characterized by an upregulated innate immune response, hypercoagulopathy state, pulmonary tissue damage, neurological and/or gastrointestinal tract involvement, and fatal outcome in severe cases of macrophage activation syndrome, which produce a ‘cytokine storm’. These systemic conditions share polymorphous cutaneous lesions where innate immune system is involved in the histopathological findings with acute respiratory distress syndrome, hypercoagulability, hyperferritinemia, increased serum levels of D‐dimer, lactic dehydrogenase, reactive‐C‐protein and serum A amyloid. It is described that several polymorphous cutaneous lesions similar to erythema pernio, urticarial rashes, diffuse or disseminated erythema, livedo racemosa, blue toe syndrome, retiform purpura, vesicles lesions, and purpuric exanthema or exanthema with clinical aspects of symmetrical drug‐related intertriginous and flexural exanthema. This review describes the complexity of Covid‐19, its pathophysiological and clinical aspects.

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Intravenous immunoglobulin in resistant livedoid vasculopathy: Analysis of a case series

Cited by 13 publications

References 10 publications

Intravenous Immunoglobulin Therapy in Livedoid Vasculopathy: Retrospective Observation of Clinical Outcome and Patient’s Activity Level

Intravenous Immunoglobulin Therapy in Livedoid Vasculopathy: Retrospective Observation of Clinical Outcome and Patient’s Activity Level

Long‐term remission of severe livedoid vasculopathy treated with a short course of intravenous immunoglobulin

Lessons from dermatology about inflammatory responses in Covid‐19

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