Livedo Reticularis
Livedo Reticularis
Key Points
Skin condition most commonly affecting the torso, legs and arms
Caused by change in bloodflow to small vessels in the affected areas, due to various factors
Consists of reddish-blue areas of skin which surround paler areas
Livedo reticularis is a skin condition which typically affects the torso, legs and arms. It consists of the development of reddish-blue areas of skin which surround paler areas in a netlike pattern. The netlike mottling may often first occur due to exposure to cold, but the condition may become permanent. Swelling and even ulceration may occur, although this is rare. . Additionally, livedo reticularis may occur in conjunction with cutis marmorata, which refers to the physiological response to cold, and cutis marmorata telangiectatica congenita, a rare congenital condition which consists of livedo and is accompanied by other abnormalities. Sneddon's syndrome is a form of systemic livedo reticularis, and commonly affects the eyes, brain or heart. Secondary livedo reticularis occurs in association with varying conditions which cause vasculitis (livedoid vasculitis, systemic lupus erythematosus, dermatomysositis, rheumatoid arthritis, lymphoma, tuberculosis) or obstructive disorders (cryglobulinemia, antiphospholipid syndrome, hypercalcemia, infections, arteriorsclerosis).
The cause of idiopathic livedo reticularis is unknown, and results from a change in bloodflow to the smaller blood vessels in the affected area, causing other vessels to dilate. It appears most often in females, either young or middle aged, and may become worse in cold weather.
Diagnosis
Key Points
Diagnosis based on appearance of the affected area
Other testing may be necessary to rule out associated conditions
Livedo reticularis is typically diagnosed based on the appearance of the affected area. Other testing may be performed if the presence of an associated condition is suspected.
Treatment
No treatment exists
Treatment of associated conditions may resolve discoloration
Discoloration may become permanent over time
There is no treatment for livedo reticularis. Cases which are idiopathic may see resolution when affected areas are rewarmed after cold exposure. Treatment of associated conditions, if one exists, may also help to resolve discoloration. However, discoloration may become permanent over time as vessels become irreversibly dilated.