Manifestazioni cutanee nella sindrome da anticorpi antifosfolipidi

The skin lesions of the antiphospholipid syndrome (APS) may be the presenting feature and/or may constitute a relatively frequent symptom of this syndrome. In fact, a wide variety of dermatological manifestations has been reported in APS. Livedo reticularis is the most common skin lesion observed in APS with a 24% overall prevalence. Necrotic skin ulcerations such as livedoid vasculitis, pyoderma gangrenosum like-lesions or post-phlebitis skin ulcers have been reported in 3-5% of APS patients. More rarely digital gangrenes, skin necrosis or anetoderma have been described. Non histologie thrombosis in small arteries and/or veins throughout the dermis and the subcutaneous fat tissue are the main histological findings. In same rare cases, signs of vasculitis such as vessel wall necrosis and leukocytoclastic infiltration may be present. Treatment of patients with skin lesions must be considered according to both the different dermatological manifestations and the clinical situation.