Letter to the Editor

Livedoid Vasculopathy in a Woman with Multiple Myeloma

Authors: Rajanshu Verma, MD, Tarik H. Hadid, MD, Radhika Dhamija, MD, John C. Moad, MD, Mark E. Loehrke, MD

Abstract

To the Editor:


A 62-year-old Caucasian woman with a history of multiple myeloma diagnosed one year ago presented with chief complaints of lower extremity rash of two weeks' duration and severe burning pain in the same area for the past four days. The patient had no known drug allergies and her medications included lisinopril, paroxetine, fexofenadine, and zolpidem, with no recent change in medications. A review of systems was unremarkable except that cold weather seemed to make the patient's rash worse. Past medical history was significant for hypertension, colonic diverticulosis, cerebral aneurysms, depression, alopecia, osteoarthritis, uterine fibroids, and hysterectomy. Family history was significant for stroke and cerebral aneurysms. The patient denied tobacco or illicit drug use, and alcohol was limited to one drink per day.

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References

1. Zaman Hairston BR, Davis MD, Pittelkow MR, et al. Livedoid vasculopathy: further evidence for procoagulant pathogenesis. Arch Dermatol 2006;142:1413–1418.
 
2. Irani-Hakime NA, Stephan F, Kreidy R, et al. Livedoid vasculopathy associated with combined prothrombin G20210A and factor V (Leiden) heterozygosity and MTHFR C677T homozygosity. J Thromb Thrombolysis 2008;26:31–34.
 
3. Callen JP. Livedoid vasculopathy: what it is and how the patient should be evaluated and treated. Arch Dermatol 2006;142: 1481–1482.
 
4. Browning CE, Callen JP. Warfarin therapy for livedoid vasculopathy associated with cryofibrinogenemia and hyperhomocysteinemia. Arch Dermatol 2006;142:75–78.
 
5. Cocuroccia B, Tonanzi T, Menaguale G, et al. Livedoid vasculopathy and skin ulcers in patients with inherited thrombophilia. Eur J Dermatol 2002;12:360–363.
 
6. Ball NJ, Wickert W, Marx LH, et al. Crystalglobulinemia syndrome. A manifestation of multiple myeloma. Cancer 1993;71: 1231–1234.
 
7. Hasegawa H, Ozawa T, Tada N, et al. Multiple myeloma-associated systemic vasculopathy due to crystalglobulin or polyarteritis nodosa. Arthritis Rheum 1996;39: 330–334.