Zhujing Zhu, Huanru Qu Department of Rheumatology and Immunology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, Peopleâs Republic of ChinaCorrespondence: Huanru Qu, Email qhrₜgyx@126. comBackground: Livedoid vasculopathy (LV) is a rare thrombotic vasculopathy characterized by ischemic lesions and painful skin ulcerations of the lower limbs. This report describes a male patient who presented with a novel co-presentation of LV, premature canities, and early-onset cataracts (EOC), a triad of symptoms not previously described in the context of vimentin (VIM) variants. Case Presentation: A 37-year-old male with an 8-year history of histopathologically confirmed LV also presented with premature canities and EOC. His mother had similar manifestations, including LV, premature canities, and EOC, suggesting a possible genetic etiology. Whole-exome sequencing revealed a heterozygous variant in the VIM gene (chr10: 17277378) in the patient, while his mother was also heterozygous, and the father was wild-type. After 3 months of tofacitinib therapy, the patientâs skin ulcers significantly improved. Conclusion: This case report highlights the first described co-presentation of a VIM variant with the triad of LV, premature canities, and EOC. The observed clinical improvement with tofacitinib is a preliminary finding that warrants further investigation as a potential therapeutic option for LV in this unique clinical context. Keywords: livedoid vasculopathy, early-onset cataract, premature canities, tofacitinib, case report
Zhu et al. (Fri,) studied this question.