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Rivaroxaban is an oral anticoagulant that directly inhibits Factor Xa. Last year, Kerk and colleagues reported that three patients with livedoid vasculopathy were treated successfully with oral rivaroxaban therapy (Br J Dermatol 2013; 168:898). This observation has now been extended in a report of two additional patients who experienced similar results at Mayo Clinic.1
Bottom line: I agree that rivaroxaban might be useful for some patients, although I have treated one patient thus far who seemed to respond initially but later clearly had no response. The use of rivaroxaban or perhaps other Factor Xa inhibitors for livedoid vasculopathy is intriguing but must await more observations wit…