Livedoid vasculopathy: does hyperhomocysteinaemia play an aetiological role?

Livedoid vasculopathy (LV) has been shown to be associated with hypercoagulability. However, relevant genetic and exogenous thrombophilic factors are not fully determined.To evaluate the frequency of hyperhomocysteinaemia (HHCE) and genotypes of hypercoagulative factors in LV patients.Plasma homocysteine level was measured in 42 LV patients. Polymorphism of MTHFR (677C T and 1298A C), PAI1 (-675 5G/4G and -844A G), and F2 (20210G A), and the F5 Leiden mutation, as well as biochemical parameters for hypercoagulability, were analysed.Of the LV patients, 62% revealed mild HHCE. Polymorphisms of MTHFR were observed in 75% and 56% and the PAI1 -675 5G/4G polymorphism in 100% and 83% of patients with and without HHCE, respectively. All LV patients with renal failure had mild HHCE. A high level of comorbidity of hypertension (99%) and diabetes type 2 (44%) were noted.HHCE seems to play a major pathogenetic role in LV. A high prevalence of further procoagulative factors might support the view that LV is a "complex disease".