Livedo reticularis

Livedo reticularis
Livedo reticularis secondary to obscure severe infrarenal aortoiliac stenosis with severe transient lactic acidosis.
SpecialtyDermatology, cardiology Edit this on Wikidata
SymptomsPurpura, mottling of the skin, blood clots, skin discoloration
CausesAutoimmune diseases, hyperlipidemia, poisons, drug abuse

Livedo reticularis is a common skin finding consisting of a mottled reticulated vascular pattern that appears as a lace-like purplish discoloration of the skin.[1] The discoloration is caused by reduction in blood flow (ischemia) through the arterioles that supply the cutaneous capillaries, resulting in deoxygenated blood showing as blue discoloration (cyanosis). This can be a secondary effect of a condition that increases a person's risk of forming blood clots (thrombosis), including a wide array of pathological and nonpathological conditions. Examples include hyperlipidemia, microvascular hematological or anemia states, nutritional deficiencies, hyper- and autoimmune diseases, and drugs/toxins.

The condition may be normal or related to more severe underlying pathology.[2] Its differential diagnosis is broadly divided into possible blood diseases, autoimmune (rheumatologic), cardiovascular diseases, cancers, and endocrine disorders. It can usually (in 80% of cases) be diagnosed by biopsy.[3]

It may be aggravated by exposure to cold, and occurs most often in the lower extremities.[4]

The condition's name derives from Latin livere 'bluish' and reticular 'net-like pattern'.[5]

  1. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1615. ISBN 978-1-4160-2999-1.
  2. ^ "livedo reticularis" at Dorland's Medical Dictionary
  3. ^ Kroshinsky; Stone, John H.; Bloch, Donald B.; Sepehr, Alireza (February 2009). "Case 5-2009 — A 47-Year-Old Woman with a Rash and Numbness and Pain in the Legs". New England Journal of Medicine. 360 (7): 711–20. doi:10.1056/NEJMcpc0807822. PMID 19213685.
  4. ^ James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "35.Cutaneous vascular diseases". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 817. ISBN 978-0-323-54753-6. Archived from the original on 2023-03-18. Retrieved 2023-03-18.
  5. ^ Sundriyal, Deepak; Kumar, Naveen; Kumar, Gaurav; Walia, Meenu (15 May 2014). "Livedo reticularis heralding hypercalcaemia of malignancy". BMJ Case Reports. 2014 (may14 4): bcr2013201371. doi:10.1136/bcr-2013-201371. PMC 4024535. PMID 24832704.