case_images: PMC11803417_01
case_images: Initial skin appearance Painful recurrent ulcers on the lateral ankles and back of both feet when LV before baricitinib used.
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case_images: Physical examination revealed multiple necrotic ulcers on the feet and ankles surrounded by erythema, porcelain white atrophic scars, and pigmentation (Figure 1).
case_images: The histological features Histopathological examination showed focal epidermal ulceration, superficial dermal edema, vascular proliferation and dilation, partial vascular endothelial cell proliferation, partial vascular wall destruction, partial vascular wall thickening and occlusion, and partial deposition of cellulose in the vascular wall. Furthermore, erythrocyte exosmosis and the infiltration of interstitial inflammatory cells were observed. (hematoxylin-eosin, x200).
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case_images: All these pathological manifestations were consistent with a diagnosis of LV (Figure 2).
case_images: Clinical Response of Livedoid Vasculopathy to Baricitinib Therapy. (A) After 2 weeks of treatment, the rash was obviously lighter in color and significantly smaller in scope, and part of the scab fell off and was covered by new skin. (B) After 3 months of treatment, the ulcers healed completely, and there was no new lesion presented. (C) the patient had only pigmentation on feet and ankle in March 2024.
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case_images: Following 2 weeks of treatment, the erythema became notably lighter in color and significantly smaller, with a part of the scab falling off and replaced with new skin (Figure 3A). The ulcers healed completely following treatment for 3 months, without any new lesions (Figure 3B). At the most recent follow-up in March 2024, the patient only had pigmentation on feet and ankles (Figure 3C).