A Case of Lividoid Vasculopathy.

4 year old female presented with non-healing ulcers on both the legs since 5 years. She was being treated by general surgeon with broad spectrum ant ib iot ic coverage and repeated debridements. Plastic surgeon was also consulted. On examination the ulcers were around the malleolus, painful, irregular in shape with erythematous margins and the floor was covered with necrotic slough. The surrounding sk in showed hyperpigmentat ion . The pat ient was invest igated for vascul i t ic pathology and also the possibility of thrombophilic state was considered. Her baseline investigations were normal and the workup for ANA, p-ANCA, c-ANCA, protein C, protein S, anti-cardiolipin antibody was negative. To resolve the diagnostic dilema, skin biopsy was undertaken which was consistent with livedoid vasculopathy. The patient was started on aspirin and dipyridamole. Marked improvement was observed in the ulcers with resolution of pain. The patient is currently on aspirin and dipyridamole.