Abstract: We report three cases of livedoid vasculopathy (LV). All patients presented with recurrent painful petechiae, ecchymoses, ulcers and atrophic plaques on both lower extremities. Histopathology revealed hyaline thrombi in small vessels of the superficial and middle dermis. Treatment with low-dose pentoxifylline combined with rivaroxaban resulted in rapid symptomatic improvement. No recurrence or obvious adverse reactions were observed during long-term follow-up. Literature review indicates that anticoagulation is the first-line therapy and stepwise management is commonly adopted in clinical practice. The combination of antiplatelet and anticoagulant therapy is effective. Corticosteroids, intravenous immunoglobulin and JAK inhibitors can be used for refractory cases, although the level of evidence is limited.

Key words: livedoid vasculopathy, thrombosis, pentoxifylline, rivaroxaban