Related Subjects:
|Nikolsky's sign
|Koebner phenomenon
|Erythema Multiforme
|Pyoderma gangrenosum
|Erythema Nodosum
|Dermatitis Herpetiformis
|Lichen Planus
|Acanthosis Nigricans
|Acne Rosacea
|Acne Vulgaris
|Alopecia
|Vitiligo
|Urticaria
|Basal Cell Carcinoma
|Malignant Melanoma
|Squamous Cell Carcinoma
|Mycosis Fungoides (Sezary Syndrome)
|Xeroderma pigmentosum
|Bullous Pemphigoid
|Pemphigus Vulgaris
|Seborrheic Dermatitis
|Pityriasis/Tinea versicolor infections
|Pityriasis rosea
|Scabies
|Dermatomyositis
|Toxic Epidermal Necrolysis
|Stevens-Johnson Syndrome
|Atopic Eczema/Atopic Dermatitis
|Psoriasis
🌐 Livedo reticularis is caused by dilatation and stagnation of blood within dermal capillaries and venules, producing a mottled, net-like discoloration of the skin.
📖 About
- A cutaneous finding, sometimes idiopathic, but often associated with connective tissue disease or vascular pathology.
- Important to distinguish between benign (physiological) livedo and pathological causes linked to autoimmune or vascular disease.
🩺 Clinical Features
- Mottled blue-red discoloration with a reticular (net-like) pattern.
- Typically seen on legs, forearms, and trunk.
- Worsens with cold ❄️ but may persist after rewarming (unlike simple cutis marmorata in children).
- May be associated with headache, dizziness, or neurological symptoms in systemic disease (e.g., Sneddon’s syndrome).
- Represents sluggish blood flow and capillary dilatation.
🧾 Causes
- Idiopathic: Often in young women, usually benign; may rarely lead to leg ulceration.
- Autoimmune/Connective Tissue Disease: RA, SLE, dermatomyositis.
- Vasculopathy/Vasculitis: Polyarteritis nodosa, antiphospholipid syndrome.
- Infective/Haematological: Cryoglobulinemia (esp. Hepatitis C–related), malignancy, hypercoagulable states.
- Cholesterol embolization after vascular procedures.
- Inherited/metabolic: Homocystinuria.
- Sneddon’s syndrome: Livedo with cerebrovascular disease (stroke risk 🚨).
🔬 Investigations
- Bloods: FBC, U&E, ANA, dsDNA, RF, clotting screen.
- Infection/Other: Hepatitis C serology.
- Imaging: CXR or vascular imaging if systemic features present.
💊 Management
- Identify and treat the underlying cause (autoimmune, embolic, infectious, or metabolic).
- Conservative measures: keep warm, avoid vasoconstrictors (e.g., smoking, sympathomimetics).
- In systemic disease: may require immunosuppressants, anticoagulation, or disease-specific therapies (e.g., antivirals in Hepatitis C).
🧠 Exam Tip
- Antiphospholipid syndrome and Sneddon’s syndrome are classic associations tested in finals → think “livedo + stroke risk.”
