Leg ulcers in the antiphospholipid syndrome may be considered as a form of pyoderma gangrenosum and they respond favorably to treatment with immunosuppression and anticoagulation.

Leg ulcers are a manifestation of antiphospholipid syndrome (APS), and characteristically respond poorly to treatment. Because the similar findings both clinical and pathological to pyoderma gangrenosum (PG), we treated these patients with a combination of immunosuppression (steroids, azathioprine or cyclosporine), acetylsalicylic acid and anticoagulation. We evaluated the response to the combined treatment with steroids, immunosuppression, acetylsalicylic acid, anticoagulation and local measures in patients with APS and leg ulcers resembling PG. We studied 8 women with leg ulcers of a cohort of 53 patients with APS (15%). Pathological findings of PG were observed in all patients. Seven patients (87.5%) received cyclosporine as usual for the treatment of PG, and all patients received steroids and anticoagulation with warfarin. Cicatrisation was present in all patients in 7 months. Leg ulcers in patients with APS may be resemble to PG, and their treatment with immunosuppression, acetylsalicylic acid and anticoagulation is effective for this severe and poorly responding condition.