{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T19:10:45Z","timestamp":1778958645423,"version":"3.51.4"},"reference-count":52,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,4,16]],"date-time":"2018-04-16T00:00:00Z","timestamp":1523836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Livedoid vasculopathy (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) is a thrombotic skin disease characterized by episodic painful ulcerations of the distal aspects of the legs. Its healing process typically leaves small porcelain\u2010white scars called <jats:italic>atrophie blanche<\/jats:italic> as a result of the occlusion of cutaneous microcirculation. The main goals of the treatment are pain management and the prevention of ulceration and of progressive scarring in the malleolar area. The therapeutic management is still a challenge, however, and most treatments were based on anecdotal off\u2010label protocols. Over such context, direct oral anticoagulants (<jats:styled-content style=\"fixed-case\">DOACS<\/jats:styled-content>) arise as a potential treatment for this disease. This class of medications became an alternative from initial large studies applied on different pathologic scenarios regarding thromboembolic events. In that line, recent case series using <jats:styled-content style=\"fixed-case\">DOACS<\/jats:styled-content>, including rivaroxaban, started to emerge in the literature related to <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> and reported successful prevention of cutaneous infarctions and ulcerations, providing physicians with a new promising alternative. The current report describes four cases of long\u2010term recalcitrant <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>, in which rivaroxaban monotherapy effectively reduced pain and cutaneous ulcerations in a few weeks of treatment without relevant side effects. The authors also review therapy management of the disease, focused on <jats:styled-content style=\"fixed-case\">DOACS,<\/jats:styled-content> and suggest a step\u2010by\u2010step approach to treat these patients, taking into consideration different resource profiles of each level of local health centers, the gravity of the cases, and risks\/benefits for patients.<\/jats:p>","DOI":"10.1111\/ijd.13997","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T03:12:53Z","timestamp":1523934773000},"page":"732-741","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The management of livedoid vasculopathy focused on direct oral anticoagulants (<scp>DOAC<\/scp>s): four case reports successfully treated with rivaroxaban"],"prefix":"10.1111","volume":"57","author":[{"given":"Gabriela","family":"Franco Marques","sequence":"first","affiliation":[{"name":"Hospital das Cl\u00ednicas da Faculdade de 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