Livedoid Vasculopathy: Analysis of Hematological Parameters and Response to Rivaroxaban

Livedoid vasculopathy (LV) is a chronic microvascular thrombosis disorder with poorly understood pathogenesis, potentially involving hypercoagulability and inflammation. The aim of this study included analyzing the association between these indices and disease severity, as well as evaluating the real-world efficacy of rivaroxaban, to determine optimal personalized treatment strategies for LV. This retrospective analysis was conducted on 41 patients with LV and 19 healthy controls. Patients were treated with 10 mg daily rivaroxaban and assessed using the Livedoid Vasculopathy Activity/Severity Score and the Numerical Rating Scale. Thirty-two females (78.0%) were included, with a mean age of 26.1 years. The platelet count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR) and plateletcrit levels were significantly increased in patients with LV compared with those in healthy controls. Platelet count, plateletcrit and PLR positively showed a positive correlation with clinical severity scores, which can serve as simple and cost-effective measures for assessing disease severity. Rivaroxaban at 10 mg daily resulted in disease control in 78.0% of patients within 3 weeks. Patients with inadequate responses exhibited higher severity scores and required dose adjustments or combination therapy. Adverse effects were generally mild, comprising 6 instances of menorrhagia, 2 cases of bleeding hematochezia and 1 allergic reaction.