LAUSR

Background Livedoid vasculopathy is a rare, chronic thrombo-occlusive disorder that primarily affects the lower extremities, causing painful ulcerative lesions. Despite its clinical significance, the prevalence and demographic characteristics of LV, particularly among patients with connective tissue diseases, remain underexplored. This study aims to investigate the prevalence of LV among patients diagnosed with CTDs, providing insight into potential epidemiological patterns. Methods The study was a retrospective cohort study conducted at Mass General Brigham (MGB), a healthcare system in Greater Boston, Massachusetts, from January 1, 2014, to June 1, 2021. Data extraction was facilitated through the Mass General Brigham Enterprise Data Warehouse utilizing the Research Patient Data Registry (RPDR) system. Data extraction includes age, gender, race and autoimmune diseases associated with LV. SPSS v 29 was used for data analysis. Results We reviewed 1730 charts; 108 patients met criteria for LV. Prevalence is reported within the screened cohort (108/1730 = 6.2%). For system context, we also report a hospital-system registered prevalence of 0.0018% (108/6,000,000) based on the RPDR population. The majority of patients were female (74.07%). The mean age of the patients with LV was 44.87 ± 8.24 years. The racial composition was white (84.25%). Among the 17 patients with autoimmune diseases, females were more represented (82.35%). Systemic lupus erythematosus was the predominant condition, affecting 58.82% of these patients. Positive results for phospholipid antibodies were found in 57.40% of patients, with a p-value of 0.065. For anticardiolipin antibodies, p-value 0.095. Hyperhomocystenemia, p-value of 0.952. Activated C resistance, p-value of 0.088. Conclusion In this cohort of patients with connective tissue diseases, livedoid vasculopathy was observed more often in women and in middle-aged adults, and it frequently co-occurred with autoimmune conditions, particularly systemic lupus erythematosus. However, none of the between-group comparisons or serological associations reached statistical significance. These results should be interpreted as non-confirmatory trends and require validation in larger, adequately powered studies.