Case Report: A Rare Presentation of Livedoid Vasculitis in a Male Patient

Abstract

Ryan Azarkhail, Yonas Tamene, Vinod Rajakumar, Kathlen Ebersol, Sritha Moram and Nason Rouhizad

A 60-year-old male with a medical history of livedoid vasculi- tis, CVA while on Coumadin, and hypertension presented to the emergency department for worsening bilateral lower extremity lesions. He reported that the sores appeared four weeks prior during a trip abroad, initially presenting on his medial and later- al lower extremities as scabs. Upon returning, two weeks prior to admission, the lesions gradually became more erythematous while also draining clear fluid. Upon urgent follow-up with his Rheumatologist, he was found to have multiple eschars on the anterior right lower leg with surrounding erythema as well as granulation tissue on his right second toe with purulent dis- charge. There was a concern for possible livedoid vasculitis flare with superimposed cellulitis, so his rheumatologist prescribed doxycycline for 14 days as well as aspirin concurrent to his baseline Eliquis which was being used to manage his livedoid vasculitis flares. Despite two days of treatment, the sores on his anterior right leg continued to increase in warmth, tenderness, and purulent discharge prompting the patient to seek emergency care.

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