 This pilot study aimed to determine the efficacy of an anti-TNF-alpha agent, etinosept, in patients with refractory livedoid vasculopathy who were resistant to steroids, anti-platelets, or Danazole therapy. Etinosept therapy resulted in fast relief of pain in a meantime of two weeks and significant improvement of quality of life, especially in rapid relief of pain. This article was authored by Eamon GAO and Heng Zheng Jin.