Livedo Reticularis



Clinical

  • Swollen, visible medium skin veins
  • Reticular mottled purplish discolouration of legs
  • Coagulation (skin and pregnancy related)
  • Exacerbated by cold weather

Differential Dx

  • Blood dyscrasia
  • Autoimmune
  • CVS
  • Cancers
  • Endocrinopathy

Diagnosis

  • Positive anti-phospholipid antibodies
  • ± anticardiolipin antibodies
  • Dx confirmed by biopsy

Types

Idiopathic

  • Benign. Young women. Winter only.

Secondary

  • SLE, RA, PAN
  • Lymphoma
  • TB
  • Clotting (anti-phospholipid syndrome)

Management

  • If no acute thrombotic complication: refer GP to arrange OPD
  • Eliminate risks (smoking, OCP, hypertension, ± Statin)
  • Aspirin in most
  • Warfarin if thrombotic state
Levido Reticularis

Content by Dr Íomhar O' Sullivan 07/12/2011. Last review Dr ÍOS 4/12/18.