The natural history of livedoid vasculitis is one of relapse and remission, with an estimated prevalence of 1:100,000 inhabitants per year, mainly women with a mean age of 30 years. The objective of the present study is to report the case of a patient with livedoid vasculitis and the difficulties in diagnosis and treatment. A 51-year-old white female patient, a 30-year smoker of one pack of cigarettes per day, presented with a chronic ulcer for 9 years on the pretibial surface of the right lower limb after local trauma. During this period, the lesion progressed with an increase in extension, affecting the lateral surface of the leg and becoming pale and painful to manipulation. The biopsy confirmed the diagnosis of livedoid vasculitis, which made it possible to establish a more appropriate therapy, although there is no consensus on one. The patient evolved with good healing of the lesion.