Livedo




(1)
Hôpital Universitaire de Strasbourg, Strasbourg, France

 




Abstract

It is important to distinguish between the following:


It is important to distinguish between the following:



  • Livedo reticularis, a netlike erythema with fine, regular, and complete (“closed”) meshes, which is more common and generally physiological.


  • Livedo racemosa with large, sometimes broken meshes, which is always pathological and characteristic of Sneddon’s syndrome, for example.


  • Infiltrated, palpable livedo associated with sometimes purpuric papules, plaques, or nodules, mainly observed in vasculitis, such as polyarteritis nodosa (cf. Fig. 15.​32).


  • Purpuric livedo or retiform purpura which is indicative of a thrombotic vasculopathy involving the dermal ­vessels with muscular walls (cf. Figs. 14.​13, 14.​14, and 14.​15); this type of livedo can be seen, for example, in disseminated intravascular coagulation or in catastrophic antiphospholipid antibody syndrome. The key significance of this livedo is discussed in Chap.​ 14.



Table 22.1
Main causes of livedo according to mechanism

















Mechanisms

Main causes

Vasomotor disorder: mainly livedo reticularis

Disorders of the central nervous system: multiple sclerosis, encephalopathy, poliomyelitis, Parkinson’s disease, stroke, traumatic brain trauma, etc.

Drugs: amantadine, vasopressors, phenylbutazone, β-blockers

Hypothyroidism, cushing syndrome, pellagra

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Oct 6, 2016 | Posted by in Dermatology | Comments Off on Livedo

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