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J Korean Rheum Assoc. 2008 Jun;15(2):165-169. Korean. Case Report.
Hur KH , Kwok SK , Park YJ , Choi JJ , Cho CS .
Division of Rheumatology, St. Mary's Hospital, School of Medicine, The Catholic University of Korea, Division of Rheumatology, Seoul, Korea.
Division of Rheumatology, CHA Hospital, College of Medicine, Pochon CHA University, Seoul, Korea.

Antiphospholipid syndrome(APS) is characterized by vascular thrombosis in association with elevated titers of antiphospholipid antibodies. Leg ulcers are a considered to be a cutaneous manifestation of APS due to thrombosis of small to medium sized vessels. We report a case of necrotic non-healing, ankle ulcers mimicking pyoderma gangrenosum associated with APS in 50-year-old man. He had a past history of autoimmune thrombocytopenia and cerebral infarction. Laboratory findings showed a circulating lupus anticoagulant, positive anticardiolipin antibodies as well as anti-dsDNA and anti-Sm antibodies. Skin biopsy of ulcer lesions showed thrombotic vasculopathy of medium sized vessels with minimal leukocyte infiltration. Ulcers were successfully treated with surgical debridement and subsequent skin graft along with anticoagulation therapy.

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