Livedoid Vasculopathy in a Young Woman With Elevated Factor VIII and Lipoprotein(a): A Case Report With Consideration of Future Pregnancy

Livedoid vasculopathy (LV) is a rare, chronic vascular disorder marked by painful, recurrent ulcerations that primarily affect the lower extremities.It is frequently associated with hypercoagulable states, although its pathophysiology remains incompletely understood.We present the case of a 25-year-old woman with a longstanding history of LV, elevated factor VIII, increased lipoprotein(a), recurrent kidney stones, and iron deficiency anemia who presented with worsening lower-extremity ulcerations.An extensive workup excluded other hypercoagulable and connective-tissue conditions, leaving elevated factor VIII and lipoprotein(a) as the most likely contributors to her disease.Although her symptoms initially resolved with treatment, they recurred over time, and management was further complicated by her desire for future pregnancy, which precluded the use of several standard anticoagulant therapies.Her regimen was ultimately centered on pentoxifylline and low-dose aspirin to control symptoms while minimizing risk to a future pregnancy.This case illustrates the importance of individualized treatment planning in LV, particularly when hypercoagulable risk factors intersect with reproductive goals.