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The term \u201cocclusive vasculopathies\u201d encompasses pathophysiologically related entities that share structural or thrombotic obliteration of small cutaneous vessels. In this article, we will focus on livedoid vasculopathy with and without antiphospholipid syndrome and calciphylaxis with differentiation from hypertonic leg ulcer as the most relevant differential diagnoses of leg ulcer. The term also includes vascular occlusion, for example due to oxalate or cholesterol embolism, and septic vasculopathy. This often leads to acral ulceration and is therefore not a differential diagnosis with classic leg ulcers. It will not be discussed in this article.<\/jats:p><jats:p>Occlusive vasculopathy may be suspected in the presence of the typical livedo racemosa or (non\u2010inflammatory) retiform purpura as a sign of reduced cutaneous perfusion in the wound area. Inflammatory dermatoses, especially vasculitides, must be differentiated. This is achieved by histopathological evaluation of a tissue sample of sufficient size and depth taken at the appropriate time. In addition, specific laboratory parameters, particularly coagulation parameters, can support the diagnosis.<\/jats:p>","DOI":"10.1111\/ddg.15276","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T06:06:35Z","timestamp":1708495595000},"page":"553-567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Occlusive cutaneous vasculopathies as cause of chronic ulcers"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8828-0980","authenticated-orcid":false,"given":"Moritz","family":"Ronicke","sequence":"first","affiliation":[{"name":"Department of Dermatology Uniklinikum Erlangen Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg (FAU)  Erlangen Germany"},{"name":"Deutsches Zentrum f\u00fcr Immuntherapie (DZI) Uniklinikum Erlangen Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg (FAU)  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0229-8931","authenticated-orcid":false,"given":"Carola","family":"Berking","sequence":"additional","affiliation":[{"name":"Department of Dermatology Uniklinikum Erlangen Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg (FAU)  Erlangen Germany"},{"name":"Deutsches Zentrum f\u00fcr Immuntherapie (DZI) Uniklinikum Erlangen Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg (FAU)  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3722-6383","authenticated-orcid":false,"given":"Cornelia","family":"Erfurt\u2010Berge","sequence":"additional","affiliation":[{"name":"Department of Dermatology Uniklinikum Erlangen Friedrich\u2010Alexander\u2010Universit\u00e4t Erlangen\u2010N\u00fcrnberg (FAU)  Erlangen Germany"},{"name":"Deutsches Zentrum f\u00fcr Immuntherapie (DZI) Uniklinikum Erlangen Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg (FAU)  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1610-0387.2010.07535.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00105-021-04759-8"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1102-6894"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.25270\/wnds\/21060"},{"issue":"7","key":"e_1_2_8_6_1","first-page":"732","article-title":"ABCDE rule in the diagnosis of chronic wounds","volume":"15","author":"Dissemond J","year":"2017","journal-title":"J Dtsch Dermatol Ges"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00105-008-1530-2"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40375"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","unstructured":"Erfurt\u2010BergeC B\u00fcltemannA GerberV MotzkusM RembeJD DissemondJ.Dermatologie (Heidelb). 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