Rivaroxaban als behandeling voor pijnlijke ulceraties bij livedoïd vasculopathie

Livedoid vasculopathy is a rare, chronic, primarily vascular
occlusive disorder mostly affecting the cutaneous
microcirculation of the lower limbs resulting in extremely
painful ulcerations with irreversible scarring. The
ulcers typically occur around the malleoli of young to
middle-aged women and heal with white round to stellate
atrophic scars (atrophy blanche). Livedoid vasculopathy
is often misdiagnosed. Although the pathogenesis of
livedoid vasculopathy remains largely unclear, several
hypercoagulability risk factors have been identified and
treatment with Rivaroxaban appears to be successful.
Rivaroxaban is a direct factor Xa inhibitor that prevents
thrombus formation. The extreme efficacy of a direct
factor Xa inhibitor both on pain relief and rapid healing
of the ulcers suggests an important role for factor Xa in
the pathogenesis of livedoid vasculopathy. In order to
avoid recurrences continuous low doses of Rivaroxaban
are being used.