Livedo Reticularis

Posted by Elaine Moore Mar 25, 2007

Livedo reticularis, which is also known as vasculitis racemosa, livedo racemosa, and livedo annularis, is an autoimmune-related skin disorder that causes a mottled, purple skin discoloration. Livedo reticularis is known to occur in several different autoimmune diseases, including systemic lupus erythematosus (SLE) , autoimmune hemolytic anemia, polyarteritis nodosa, dermatomyositis, rheumatoid arthritis cold agglutinin syndrome, cryoglobulinemia, vasculitis, and antiphospholipid syndrome. Livedo reticularis can also occur in other conditions such as lymphoma, pancreatitis, and tuberculosis.

Symptoms

Livedo reticularis causes a constriction or narrowing of the fine capillary blood vessels that feed the upper layers of the skin. In livedo reticularis, over time dilation of these vessels causes the blood to stagnate, which causes a mottled discoloration of the overlying skin. The rash in livedo reticularis is described as a reticular or lacy, net-like purplish coloration surrounding a pale central area.

Livedo reticularis occurs primarily on the legs, arms, and trunk with symptoms becoming more pronounced in cold weather. The mottled appearance is related to spasms that occur in the dilated vessels. Mottling is more common in the forearms, thighs and lower abdomen.

Sneddon’s Syndrome

Sneddon’s syndrome is a form of idiopathic or autoimmune livedo reticularis with systemic involvement. The blood vessels most affected are those in the brain, eye, and heart. Idiopathic livedo reticularis primarily occurs in young and middle-aged females.

Treatment

There is no treatment for livedo reticularis. Rewarming the skin may reverse the discoloration although eventually the capillaries become permanently dilated and the condition results in permanent discoloration.

Resources

Teresa Kauke, Livedo Reticularis and Cold Agglutinins, Tbe New England Journal of Medicine, Jan 18, 2007, vol 356 (3): 284.

Livedo Reticularis, DermNet NZ, accessed Jan 10, 2007.