Livedo racemosa in neurological diseases: an update on the differential diagnoses

Abstract

Livedo is a net‐like violaceous skin pattern. It can be classified as physiological or pathological. The physiological livedo reticularis usually appears in cold conditions, whereas the pathological and irregular livedo, which persists in warm temperatures, is often labeled as ‘livedo racemosa’. Some neurological pathologies are associated with livedo, most commonly those with an inflammatory component or those derived from systemic disorders. The present review summarizes the most important central and peripheral neurological diseases in pediatric and adult age groups associated with livedo, providing physicians with an overview of the clinical presentation, etiology, diagnosis and management of these conditions.

A Patient with Recurrent Strokes: Approach to Coagulopathy

“…Dense lymphocytic inflammatory infiltrates can be found in lymphocytic thrombophilic arteritis (LTA), a primary lymphocytic vasculitis that presents with LRa or macular hyperpigmentation 18 . Interstitial neutrophil and macrophage infiltration is commonly found in DADA2 9 , as previously described in this paper, but hyalinization, thickened blood vessel walls, fibrin deposition, vascular occlusion by thrombosis, and minimal inflammation are typical of livedoid vasculopathy, a rare chronic vascular disorder characterized by persistent painful ulceration of the lower extremities 19 .…”

“…The major clinical feature is vasculopathy/vasculitis of small and medium sized arteries. Around 50% of patients have presenting symptoms of LRa, stroke, and fever 9 . The diagnostic gold standard for DADA2 is the detection of ADA2 gene mutations.…”

“…Around 50% of patients have presenting symptoms of LRa, stroke, and fever. 9 The diagnostic gold standard for DADA2 is the detection of ADA2 gene mutations. The onset of presentation of DADA2 and the lack of ADA2 mutations make this diagnosis unlikely for this case.…”

Cutaneous manifestations in Moyamoya angiopathy: A review

“…Livedo racemosa is a pathological, netlike violaceous skin pattern that persists in warmth due to an intraluminal or vessel wall pathology [21] (Figure 3). It has an incidence of up to 12.8% in MA patients, thus reflecting a possible sign of global vasomotor dysfunction [22,23].…”