Livedo Reticularis

Livedo Reticularis






Livedo reticularis is a condition marked by purplish color of the skin caused by dilation of blood vessels which stops the normal blood flow. This is marked by discoloration of the skin which becomes reddish blue in color. The sub-cutaneous layer of the skin changes its normal color and becomes pale. This situation is seen on the palms, legs and trunk and affects people largely during cold weather.

But this disease affects only the superficial blood vessels and hence does not harm the underlying blood capillaries and blood vessels. It causes net like or mesh like appearance on the skin with dark blue or purple color. Cold climate triggers the dilation of superficial blood vessels causing discoloration of the skin.

Causes :

Underlying medical issues can cause livedo reticularis in some people. For instance cutis marmorata can cause this problem in infants when they are exposed to cold weather. It often occurs as temporary diffusion and does not produce any visible symptoms. For some children livedo reticularis is inherited due to chromosomal abnormalities or due to neurological problems. The condition can be severe in the beginning but it may improve as one grows old.

LR is a benign disorder causing mottling looks on the upper skin layer. It happens due to the swelling of blood vessels or capillaries which causes more blood flow into particular area causing red or purple coloration.

The normal blood flow is blocked due to obstructions like infections or blood clotting which causes disruption in the mechanism of transfer of blood. This will activate the underlying blood vessels to swell thus supplying more volumes of blood to the superficial layer of skin. This can cause prolonged vaso-dilation giving rise to discoloration.

Idiopathic livedo reticularis affects middle aged people during winter. Initial symptoms of mottling are seen during cold season accompanied with tingling sensation on the arms and legs. This can be due to inflammation of blood vessels or due to obstruction of free flow of blood. This disease can occur in combination with Rheumatoid Arthritis, Dermatomyositis, systemic lupus, lymphoma and Pancreatitis.

Obstruction in the pathway of blood can occur due to infections like Syphilis, Blood Clots formed from sticky platelets, due to large volumes of calcium deposits, presence of excess of red blood cells and due to cholesterol emboli. This condition can also happen as side effects of medicine like Amantadine.

When you should consult a doctor?

If you have purple blue colored skin on the legs marked by net or mesh like appearance it can be due to livedo reticularis. Iif you have pain or swelling on the area you need to consult your doctor without any delay.

Symptoms :

Signs of LR vary widely on individuals. Some of the common symptoms of this disease are blue or purple colored skin rash giving irregular pattern on the legs, netlike distribution of purple coloration on the skin measuring 2-3cm in diameter. There may not be any defined borders for the rash since it would be pale in color. This will not cause irritation or pain or discomfort.

For some people it can cause tingling sensation or numbness on the arms and legs if accompanied by specific diseases. There can be swelling or inflammation on the affected area and in severe cases it can form ulcers.

Pictures of Livedo Reticularis :

Images, Pics, Pictures and Photos of Livedo Reticularis

Treatment :

Since the disease causing discoloration of skin is harmless and benign no treatment is required. However if the condition is accompanied by swelling or ulcerous growth your doctor will examine the position and give suitable treatment.

Livedo reticularis occurs due to pooling of blood on particular areas of lower legs causing discoloration. You should not apply anything cold on the affected area. Usually the mottling mesh like appearance will not heal and these types of changes are permanent on the skin.

For people suffering from chronic illness like rheumatoid arthritis anti-inflammatory drugs are prescribed to reduce swelling. Anticoagulants are given depending on the symptoms of the patients. Some people will be given corticosteroid injection for getting immediate relief from swelling and discomfort feeling.

The legs can be kept at elevated position for regularizing the blood flow. Proper care of your foot is advised for reducing the adverse effects of reduced blood supply on the lower legs.

Doing regular exercise can improve blood circulation and helps dilation of blood vessels. Avoid going out barefoot in cold weather.

Livedo Reticularis – Symptoms, Causes, Treatment, Pictures

Livedo Reticularis – Symptoms, Causes, Treatment, Pictures

What is Livedo Reticularis?

Primary Livedo Reticularis or more commonly known as Livedo Reticularis is a common benign vascular condition which commonly affects the superficial blood vessels and capillaries. Livedo Reticularis has a mottled net-like or lace-like appearance with purplish or bluish discoloration which is non-blanchable. The presentation of this disease is evident on the skin of the arms, legs, palms and soles and in rare cases includes the torso. This condition is usually aggravated by cold temperature or may be a symptom of other underlying disease. A detailed medical history and determination of the course of the disease is important to rule in Livedo Reticularis.

Livedo Reticularis Symptoms

Symptoms of Livedo Reticularis vary on each case. A number of clinical test and measures are used to examine Livedo Reticularis. A few of the more commonly used are CBC, ANA, coagulation test and biopsy. The following are the common signs and symptoms reported:

• Purplish or bluish rash with an irregular pattern


• Netlike pattern with a diameter of mesh less than 3cm


• Non pruritic rash (not itchy)


• No distinct border (some areas may be pale)


• Painful or swollen associated joints


• Tingling or numbness


• Swelling of the area


• In severe and rare cases, leads to ulcers

Livedo Reticularis Causes

Livedo Reticularis is an idiopathic and benign disorder. Several factors may cause the mottling appearance of the skin. This is brought about by swelling of medium sized blood vessels including capillaries which results into pooling of blood into that area. There is an interruption to the normal blood flow brought about by vascular obstructions from infections, Blood Clots or vessel wall anomalies like in Calciphylaxis. With normal physiology a network of vessels are responsible to provide enough blood to the more superficial ones. Due to the presence of obstructions or inflammations there is a disruption on the mechanism leading to scarcity of blood to the superficial vessels. As a compensatory mechanism, the underlying blood vessels swell to continually supply blood to the more superficial ones. This compensatory effect causes spasm and prolonged vasodilation trapping some blood on a particular area thus a cutaneous discoloration appears.
In some instance, it is thought to be due to a reaction from cold weather where Vasoconstriction of blood vessels occur which is common among children and adults. In some studies there is a greater incidence of Livedo Reticularis on people leaving on colder countries. Some of this resolve spontaneously and others may leave a permanent changes in the skin. Another acceptable fact of the cause of Livedo Reticularis is hormonal changes or an autoimmune response which occur more commonly among women during third decade of life.

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Systemic Lupus Erythematosus, Rheumatoid Arthritis, Sneddon’s syndrome and some form of cancers are among the conditions that presents Livedo Reticularis during the course of their progression. An immediate consultation to a medical professional is necessary to determine the causative factor of Livedo Reticularis especially if it is reoccurring more often. Livedo Reticularis is also brought about by an allergic reaction or side effect from certain drugs or medicines especially those containing with Hydroxyurea or cocaine.

Livedo Reticularis Treatment

Treatment for Livedo Reticulatris may be conservative or focused on the specific symptoms. There is no specific drug intervention that can cure Livedo Reticularis. One of the causative factor is the pooling of blood which is common on the lower legs. This can be immediately treated by exercise like ankle pumping, leg elevation and application of warm modalities to increase lower extremity circulation. Avoid cold application on affected areas. Over time the symptom of skin mottling does not reverse and becomes permanent even with changes in temperature. For systemic involvement like in Rheumatoid Arthritis, an anti-inflammatory medication is needed to decrease and alleviate associated pain and swelling. Administration of anticoagulants, antiplatelets and corticosteroids show improvement. Since circulation is poor, in severe cases an ulcer may develop, proper foot care and shoes should be advised to lessen the adverse effect of poor blood supply. If the symptoms become severe or reoccurring consult a doctor immediately.

Livedo Reticularis Pictures