Livedo reticularis (LR) is a mottled bluish (livid) discoloration of the skin that occurs in a netlike pattern. It is not a diagnosis in itself but a reaction pattern.
It occurs mostly on the legs, arms and trunk and is more pronounced in cold weather. The mottled look seen in a person with livedo reticularis occurs when some of the blood vessels feeding the skin go into spasm. Symptoms of livedo reticularis include a mottled, or lace-like, appearance of reddish blue areas on the skin
Classification
Idiopathic livedo reticularis (ILR) is a purple/ livid discoloration of the skin that occurs in a netlike pattern (diameter of mesh <3 cm). It involves large areas of the lower, sometimes upper extremities and the trunk and disappears after warming. It is a physiologic phenomenon.
Secondary (symptomatic) livedo Reticularis (SLR) is a purple discoloration that occurs in a starburst or lightning-like pattern, netlike but with open (not annular) meshes and is mostly, but not always confined to the lower extremities and buttocks. It is not a diagnosis in itself but a reaction pattern and often indicative of serious systemic disease. Because it differs clinically from ILR and also has a different significance, European dermatologists prefer the term livedo racemosa.
Sneddon’s Syndrome refers to extensive SLR with hypertension, cerebrovascular accidents, and transient ischemic attacks.
Treatment
There is no treatment for livedo reticularis. Rewarming the area in idiopathic cases or treatment of the underlying cause of secondary livedo may reverse the discolouration. However, over time the vessels become permanently dilated and livedo reticularis becomes permanent regardless of the surrounding temperature.
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