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Livedo Reticularis

Blue-reddish skin discoloration often localized in the lower extremities is characteristic of livedo reticularis. This is due to dilation of capillary blood vessels and stagnation of blood within the vessels thus causing a mottled discoloration of the skin. The skin disorder is described to be reticular (net-like) cyanotic (reddish blue discoloration) cutaneous discoloration surrounding pale central areas. The disease usually represents an idiopathic condition that can be associated with systemic disease.

Livedo reticularis is prominent during cold weather conditions occurring mostly on the legs, the arms, and the trunk. The mottled look of the skin is caused by spasm of the blood vessels feeding the skin. The symptoms for this skin disorder include mottled, or lace-like, appearance of reddish blue areas on the skin. The mottling though can be prominent on the forearms and the thighs as well as the lower abdomen. Because of the redistribution of blood flow from the blood vessels, they tend to dilate to compensate for the lost blood. This condition may arise for a variety of reasons.

Some common conditions associated with livedo reticularis are cutis marmorata telangiectatica congenita and idiopathic livedo reticularis. Temporary livedo of about 50% of infants and many adults when exposed to the cold is caused by cutis marmorata. This is actually a rare condition in which livedo is present at birth or soon after. It may also be a physiologic response to the cold. This becomes more intense and persistent with conditions associated with debility and other factors causing stasis within blood vessels. Diffuse, temporary, mild and usually symptomless mottling occurs with cutis marmorata. Other congenital abnormalities will include neurological and intellectual problems that can also be familial. It can usually be severe but it's been noted to improve with age.

Idiopathic livedo reticularis on the other hand mostly occurs among young and middle-aged females during winter. Formation of mottling occurs at first exposure to cold only but this may become permanent. Signs and symptoms will include a tingling and numbness on exposure to cold. There can also be swelling and rare ulcers. The livedo may also occur on rare occasions during spring and summer months through ulceration and swelling of the feet and ankles. Another condition, Sneddon's syndrome, a form of idiopathic livedo reticularis with systemic involvement may affect blood vessels in the brain, eye and heart.

Livedo reticularis has no known treatment. It is recommended to rewarm the area in idiopathic cases or to treat the underlying secondary livedo to reverse the discoloration. But over time, the vessels can become permanently dilated and livedo reticularis becomes permanent irregardless of the surrounding temperature.