A 34-Year-Old Woman With Knots on Her Leg and Reddening Skin

Padma Chitnavis, MD; Mary Maiberger, MD


May 19, 2023

Treatment of APS, similar to the treatment of thrombophlebitis in general, can be achieved with LMWH and the novel anticoagulants, such as rivaroxaban. Warfarin is considered first-line therapy for APS, except in pregnant women, for whom it is contraindicated due to the risk of teratogenicity. Low-dose aspirin has been used as prophylaxis, although evidence of its benefits for this condition are limited. Anecdotal reports exist of clopidogrel use, especially for those patients unable to tolerate aspirin.

For patients with a concurrent diagnosis of SLE, such as was the case with the patient in this vignette, hydroxychloroquine is a worthwhile consideration due to its inherent antithrombotic properties.[14] Other risk factors contributing to thrombophilia (eg, smoking) should be minimized, and treatment for concurrent medical conditions should be optimized.


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