How do you approach management of a patient with lower extremity ulcers from livedoid vasculopathy with a history Sjogren’s and Factor V Leiden?  

Assess for additional procoagulant risk factors (smoking, phospholipid Abs, estrogen, paraprotein), and mitigate.Maximize pain management and wound care.In Sjogren's with vasculopathy, pts have responded to hydroxychloroquine, aspirin, and pentoxifylline. When lesions resolve, have continue hydroxyc...

Agree with Dr. @Carteron's comments. Patients with systemic Sjogren's can develop not just a vasculopathy but a true vasculitis in their lower extremities, with palpable purpura. This should be taken into consideration when evaluating such patients. I would also order a hepatitis C antibody, and a S...