SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

Information for Patients

View all Images (28)

Livedo reticularis in Adult
Other Resources UpToDate PubMed

Livedo reticularis in Adult

Contributors: Romi Bloom MD, Susan Burgin MD
Other Resources UpToDate PubMed


Livedo reticularis (LR) is a common vascular reaction pattern characterized by a reticular (net-like) discoloration on the extremities and trunk. It is caused by decreased blood flow to the skin or impaired outflow in the dermal venous plexus and stagnation of the blood within these vessels. The darker, discolored areas represent accumulation of deoxygenated blood. Etiologic categories include vasospasm, vessel wall dysfunction (eg, vasculitis), and vascular flow compromise as in coagulopathies.

LR is exacerbated by cold temperatures. It may be physiologic (cutis marmorata), a primary disease (as in idiopathic cases), or it may be secondary to underlying disorders such as antiphospholipid antibody syndrome, vasculopathies, or autoimmune connective tissue disorders. Amantadine, quinidine, and catecholamines have also been described as triggers. Drugs used in the past to treat syphilis (bismuth and arsphenamine) also caused LR. Furthermore, infections can induce LR via the formation of cryoglobulins, cold agglutinins, septic emboli, immune vasculitis, or septic vasculitis. In adults, LR is frequently seen in patients with Raynaud phenomenon, in those with a predisposition to chilblains and acrocyanosis, and in patients with poor vascular flow (eg, peripheral vascular disease and cardiac failure).

These secondary forms may also present with livedo racemosa, where the reticular pattern is asymmetric, discontinuous, and localized. Localized forms may be associated with vasculitis. In severe cases, the extremities are cold and ulcers may form.

Sneddon syndrome is extensive diffuse LR or livedo racemosa with cerebrovascular disease (from transient ischemic attacks to frank cerebrovascular accidents), hypertension, and antiphospholipid antibodies.


R23.1 – Pallor

238772004 – Livedo reticularis

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

Subscription Required

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required

Drug Reaction Data

Subscription Required


Subscription Required

Last Reviewed:07/25/2018
Last Updated:09/03/2018
Copyright © 2024 VisualDx®. All rights reserved.
Patient Information for Livedo reticularis in Adult
Print E-Mail Images (28)
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
Livedo reticularis in Adult
A medical illustration showing key findings of Livedo reticularis : Reticular - netlike, Blanching patch
Clinical image of Livedo reticularis - imageId=327523. Click to open in gallery.  caption: 'Reticulate violaceous patches on the leg.'
Reticulate violaceous patches on the leg.
Copyright © 2024 VisualDx®. All rights reserved.