From the Research
Diagnosis of Livedo Reticularis
- Livedo reticularis is a violaceous mottling of the skin with a "fishnet" reticular appearance 1
- It can be primary or secondary, with secondary livedo reticularis often associated with underlying systemic diseases such as connective tissue diseases, vasculitis, hypercoagulability, and embolic events 2
- Diagnosis involves laboratory investigations to rule out systemic involvement and biopsy to confirm the presence of perivascular mononuclear cell infiltrate and arteriole thickening 3
Treatment of Livedo Reticularis
- Most patients with primary and secondary livedo reticularis are asymptomatic and do not require treatment 1
- For patients with mild symptoms, avoidance of cold and vasoconstricting substances is recommended, along with judicious dosing of a vasodilator such as a calcium channel blocker 1
- Patients with secondary livedo reticularis or livedo racemosa may benefit from treating the underlying cause, and antiplatelet and/or anticoagulant therapy may be required in certain cases 1
- Oral pentoxifylline and nifedipine have been used to treat livedo reticularis, with mild improvement seen in some cases 3
- The aim of treatment is to establish the cause of livedo reticularis and address any underlying systemic processes 4
Causes and Associations
- Livedo reticularis can be associated with various diseases, including antiphospholipid antibody syndrome, Sneddon's syndrome, and chronic natural killer cell leukemia 1, 2
- It can also be caused by an interruption of blood flow in the dermal arteries, due to spasm, inflammation, or vascular obstruction 4
- Livedo racemosa is a pathologic variant of livedo reticularis, commonly associated with antiphospholipid antibody syndrome 5