Livedo reticularis is a blue-reddish skin discoloration and most often localized in the lower extremities. The pathological mechanism of this is poorly understood. Probably it is related to the peripheral blood flow redistribution. Livedo reticularis mostly represents an idiopathic condition but may be associated with systemic diseases.
Causes of Symptomatic Livedo Reticularis
LR pattern due to vasospasm or obstruction of perpendicular arterioles, perforating dermis from below. Cyanotic periphery of each web of net caused by deoxygenated blood in surrounding horizontally arranged venous plexuses. When factors such as cold cause increased viscosity/low flow rates in superficial venous plexus, further deoxygenation occurs and cyanotic reticular pattern becomes more pronounced. Elevation of limb decreases intensity of color due to increased venous drainage. LR may result from arteriolar disease causing obstruction to inflow and blood hyperviscosity or from obstruction to outflow of blood in venules.
Symptoms of Symptomatic Livedo Reticularis
Skin looks mottled, blotchy, and reticulated without distinct borders. It has a network pattern and a bluish, reddish discoloration. It does not blanche. It may be more pronounced with cold weather
Diagnosis
Clinical diagnosis confirmed by laboratory data supporting diagnosis of associated disorder.
Treatment
Keep from chilling. Pentoxifylline, 400 mg PO tid. and low-dose aspirin may be helpful. Treat associated disorder.
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