White atrophy as a primary manifestation of the antiphospholipid syndrome. Presentation of a patient

Abstract

The vasculitis livedo represents a pattern of response to multiple causes that come together in a procoagulant state of the vessels of the dermis and superficial subcomplexion , resulting in painful scars and characteristics of chronic clinical course with exacerbations ulcers. Scars of white atrophy type Milian , often surrounded by a vicarious hyperpigmentation. Patient of 35 years of age, female sex , obstetric history of two years pregnancies and two normal deliveries, in both malleolar regions , maculopapular lesions purplish red left a whitish and atrophic scar is presented. An ill skin biopsy showed  coagulation necrosis segmental with epidermal and dermal involvement accompanied by dilation of capillaries, hyaline thrombi and extravasation of red blood cells; absent inflammatory infiltrate . The histological findings were consistent with vasculitis livedo versus cryoglobulinemia (white atrophy). High title type IgG was confirm with anticardiolipin , antinuclear antibodies and anti - neutrophil cytoplasmic antibodies were negative were found.