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Remission of long-standing livedoid vasculopathy using a whole foods plant-based diet with symptoms recurrent on re-challenge with standard Western diet
  1. Morgen Smith1,
  2. Nicholas Wright1,2,
  3. Patrick McHugh3 and
  4. Bruce Duncan4
  1. 1 Plant Based New Zealand Health Trust, Gisborne, Gisborne, New Zealand
  2. 2 Three Rivers Medical, Gisborne, New Zealand
  3. 3 Tairawhiti District Health, Gisborne, New Zealand
  4. 4 Hauora Tairawhiti, Gisborne, New Zealand
  1. Correspondence to Morgen Smith; morgensm{at}


A 63-year-old woman presented with ulcerations of both lower legs. Symptom onset was 2006. In 2013 she saw a dermatologist and a biopsy suggested livedoid vasculopathy. In 2016 a whole food plant-based diet (WFPB) was advised as a potential treatment in the community setting. The patient changed her diet accordingly, but was not otherwise treated. The symptoms remitted completely with close adherence to the WFPB diet and recurred on multiple occasions associated with poor dietary adherence. There was a self-identified dose–response relationship with degree of adherence and number and intensity of flares. There were no known adverse side effects from the diet change, although the patient felt adherence to be difficult at times. The mechanism is not completely clear; we speculate that the dietary changes directly affect vascular endothelial health, which in turn affects propensity towards a prothrombotic state. More research is needed to elucidate potential mechanisms.

  • dermatology
  • cardiovascular medicine
  • nutrition and metabolism
  • diet

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  • Contributors NW identified and managed the case. MS and NW prepared the manuscript. BD and PM revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MS and NW offer free online resources plant-based diets.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.