Livedo reticularis in Adult
Localized forms may be associated with vasculitis. In severe cases, the extremities are cold and ulcers may form. Sneddon syndrome is extensive diffuse livedo reticularis in a typical racemose, or broken, pattern with cerebrovascular disease (from transient ischemic attacks to frank cerebrovascular accidents); hypertension and antiphospholipid antibodies are often present. Livedo reticularis is also seen in patients with poor vascular flow (eg, peripheral vascular disease and cardiac failure). There is strong literature evidence for currently used drugs – amantadine, quinidine, and catecholamines – as triggers. Drugs used in the past to treat syphilis – bismuth and arsphenamine – also caused livedo reticularis.
R23.1 – Pallor
238772004 – Livedo reticularis
- Erythema ab igne is a form of fixed reticulate dyspigmentation in skin with chronic repeated heat exposure.
- Cutis marmorata telangiectatica congenita
- Reticular erythematous mucinosis is a form of cutaneous mucinosis affecting the upper chest with prominent redness.
- Collagen vascular diseases or vasculitis (polyarteritis nodosa, SLE, rheumatoid arthritis, dermatomyositis)
- Hematologic or hypercoagulable conditions (antiphospholipid antibody syndrome, cryoglobulinemia, polycythemia vera, protein C or S deficiency, HIT, TTP / HUS, paroxysmal nocturnal hemoglobinuria, etc)
- Livedoid vasculopathy
- Embolic phenomena (cholesterol, fat, septic emboli)
- Deposition diseases (calciphylaxis, oxalosis)
- Medications (amantadine, warfarin, interferon, minocycline, gemcitabine, quinidine, etc)
- Infections (hepatitis C, Mycoplasma, endocarditis, meningococcemia, syphilis, Rickettsia, M. leprae [Lucio phenomenon], etc)
- Neoplasms (renal cell carcinoma, pheochromocytoma, some hematologic malignancies)
- Neurologic disorders (multiple sclerosis, Parkinson disease, reflex sympathetic dystrophy, Sneddon syndrome)
- Endocrine / metabolic conditions (hypercalcemia, hypothyroidism, carcinoid syndrome)
- Miscellaneous (chronic pancreatitis, heart failure, Degos disease)
- Pernio is cold-induced distal blisters or ulcers associated with cold and high humidity.