Fazhan Ban, Mengyu Zhang, Daopei Zou, Yuan Yuan, Gang Wang, Wenjun Liao, Lei Wang
Introduction: Livedoid vasculopathy is a relatively uncommon chronic, recurrent occlusive vascular disorder. Previous reports on this condition have largely been based on small retrospective studies. Objectives: To analyze epidemiological patterns, clinical manifestations, histopathological features, laboratory parameters, therapeutic interventions, and prognostic outcomes of Chinese patients with livedoid vasculopathy. Methods: Patients with livedoid vasculopathy diagnosed in a single dermatology center between January 2010 and October 2022 were included for retrospective analysis. Results: A total of 358 patients were included in the study. A female predominance was observed (male-to-female ratio 1:2.4). The mean age at onset was 28.0 ± 15.4 years (median: 23 years), with the highest proportion of patients (149/358, 41.6%) developing symptom onset before age 20 years. The common alternate clinical diagnoses were allergic vasculitis and Henoch-Schönlein purpura. Disease exacerbation during summer occurred in 82.4% (150/183) of patients. Beyond classic symptoms, atypical presentations included pigmented purpuric dermatosis-like lesions (64/358, 17.9%) and stasis dermatitis-like lesions (12/358, 3.4%). Of a total of 409 treatment episodes, 70.7% involved anticoagulation therapy, both as a monotherapy and in combination regimens. During follow-up, 62.3% (147/236) of patients experienced recurrences within two years. Conclusions: At our center, livedoid vasculopathy is not uncommon, and affected patients exhibit a substantially younger age at onset. Certain livedoid vasculopathy cases demonstrate atypical clinical presentations, such as pigmented purpuric dermatosis-like lesions or stasis dermatitis-like lesions. In our cohort, the primary therapeutic approaches consist of anticoagulation therapy alone or in combination with other medications. However, these strategies are associated with a high recurrence rate.