{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:27:26Z","timestamp":1786987646477,"version":"build-2736575974"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Livedoid vasculopathy (LV) is a chronic thrombotic microangiopathy characterized by painful ulcerations that significantly impair quality of life. Management of refractory LV remains challenging as conventional therapies have limited efficacy. We report two female patients with chronic, painful ulcers unresponsive to multiple intravenous immunoglobulin cycles who achieved complete ulcer healing and rapid pain resolution following a combined regimen of CHAP therapy,\u00a0comprising nifedipine, hydroxychloroquine, aspirin and pentoxifylline, compression bandaging and punch grafts. Patient 1 is a 60-year-old woman who is a current smoker with hypothyroidism. She showed complete ulcer closure within 28\u2005days and full analgesia by day 21, maintaining remission at 1-year follow-up. Patient 2 is a 55-year-old woman with diabetes and rheumatoid arthritis who achieved near-complete healing within 9 weeks, with rapid pain relief and no adverse events. This novel multimodal approach addresses key aspects of LV pathogenesis, including impaired vasodilation, platelet aggregation and immune dysregulation. It is complemented by the analgesic and reparative benefits of punch grafting. Our findings suggest that CHAP therapy combined with punch grafts may represent a safe and effective treatment option for patients with refractory LV. This therapy merits further evaluation in controlled studies.<\/jats:p>","DOI":"10.1093\/ced\/llag149","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T11:48:27Z","timestamp":1775216907000},"page":"1685-1688","source":"Crossref","is-referenced-by-count":0,"title":["Refractory livedoid vasculopathy successfully treated with CHAP therapy and punch grafts: two case reports"],"prefix":"10.1093","volume":"51","author":[{"given":"Mar\u00eda del Se\u00f1or","family":"G\u00f3mez Mar\u00edn","sequence":"first","affiliation":[{"name":"Department of Dermatology, Hospital Universitario Reina Sof\u00eda , C\u00f3rdoba ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Juan Cencerrado","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital Universitario Reina Sof\u00eda , C\u00f3rdoba ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Su\u00e1rez Vergne","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital Universitario Reina Sof\u00eda , C\u00f3rdoba ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"2026081712355676600_llag149-B1","doi-asserted-by":"crossref","first-page":"1012178","DOI":"10.3389\/fmed.2022.1012178","article-title":"Livedoid vasculopathy: a diagnostic and therapeutic challenge","volume":"9","author":"Burg","year":"2022","journal-title":"Front Med"},{"key":"2026081712355676600_llag149-B2","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.ijwd.2021.08.013","article-title":"Livedoid vasculopathy: a multidisciplinary clinical approach to diagnosis and management","volume":"7","author":"Bilgic","year":"2021","journal-title":"Int J Womens 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vasculopathy","volume":"10","author":"Huang","year":"2022","journal-title":"Vaccines"},{"key":"2026081712355676600_llag149-B6","doi-asserted-by":"crossref","first-page":"1008392","DOI":"10.3389\/fimmu.2022.1008392","article-title":"Baricitinib is potentially effective in the treatment of refractory livedoid vasculopathy","volume":"13","author":"Han","year":"2022","journal-title":"Front Immunol"},{"key":"2026081712355676600_llag149-B7","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/j.jaad.2022.06.1188","article-title":"A novel combination (\u2018CHAP\u2019) regimen for management of livedoid vasculopathy in 12 patients","volume":"88","author":"Coromilas","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"2026081712355676600_llag149-B8","first-page":"604","article-title":"Management of chronic ulcers: punch grafting","volume":"18","author":"Koulouri","year":"2022","journal-title":"Rev Med 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