Livedo reticularis: An update

Gibbs, Mark B.; English, Joseph C.; Zirwas, Matthew J.

doi:10.1016/j.jaad.2004.11.051

Cited by 120 publications

(130 citation statements)

References 89 publications

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“…Livedo is secondary to organic or functional disorders of the eff erent dermohypodermal arterioles that will induce deoxygenation in the superfi cial venous plexus. Possible causes include: vasospasm caused by cold (primary/idiopathic livedo), arterial embolism, increased blood viscosity, Sneddon's syndrome, some drugs including phenylbutazone, and vasculitis (secondary livedo) [9]. The idiopathic form aff ects especially young women and is benign.…”

Section: Recommendationmentioning

confidence: 99%

ESVM guidelines – the diagnosis and management of Raynaud’s phenomenon

Belch

Carlizza

Carpentier

et al. 2017

Vasa

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Abstract. Regarding the clinical diagnosis of Raynaud’s phenomenon and its associated conditions, investigations and treatment are substantial, and yet no international consensus has been published regarding the medical management of patients presenting with this condition. Most knowledge on this topic derives from epidemiological surveys and observational studies; few randomized studies are available, almost all relating to drug treatment, and thus these guidelines were developed as an expert consensus document to aid in the diagnosis and management of Raynaud’s phenomenon. This consensus document starts with a clarification about the definition and terminology of Raynaud’s phenomenon and covers the differential and aetiological diagnoses as well as the symptomatic treatment.

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Section: Recommendationmentioning

confidence: 99%

ESVM guidelines – the diagnosis and management of Raynaud’s phenomenon

Belch

Carlizza

Carpentier

et al. 2017

Vasa

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“…Livedo reticularis can be secondary to numerous and heterogeneous causes and systemic diseases [4]. Differential diagnosis should especially focus on elements that suggest potential autoimmune conditions or thrombotic disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Differential diagnosis should especially focus on elements that suggest potential autoimmune conditions or thrombotic disorders. In fact, livedo reticularis can be associated with autoimmune (in particular lupus erythematosus), thrombotic or vessel wall diseases [4], but has not been reported to be related to heat exposure [4].…”

Section: Discussionmentioning

confidence: 99%

Erythema ab igne

et al. 2010

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An 86-year-old woman was referred to our Clinic because of a new onset of anaemia. She was under treatment with warfarin for chronic atrial fibrillation. The INR at admission was 4.1. Her caregiver excluded hematemesis or melena, and assured no NSAID had been taken. She appeared pale and was haemodynamically stable. A wellmarked, reddish-brown, netlike discoloration of the skin, with clear-cut margins was present on the anterior and medial surfaces of both thighs (Fig. 1). This kind of lesion was not present in any other body areas. Physical examination was otherwise normal.Routine blood examination revealed the presence of a microcytic anaemia (haemoglobin 7.8 g/dL; mean corpuscular volume 60.8 fL) with iron deficiency (serum iron 20 lg/ dL; serum ferritin 30 lg/L). The erythrocyte sedimentation rate appeared high (75 mm/h). Lupus anticoagulant panel, antinuclear antibodies, Coombs tests, cryoglobulins and anti-HCV antibodies were normal. Haptoglobin levels were normal. Esophagogastroduodenoscopy showed a sliding hiatal hernia with erosive esophagitis.The patient reported that the skin discoloration had appeared on her thighs many years before, and was chronic and stable. She added she would usually keep a hot water bottle on her thighs. It is to be noted that the extension of the lesion corresponded to the surface of the water bottle.Therefore, the skin discoloration and anaemia likely had no relationship. In fact, the anaemia was secondary to erosive esophagitis, and was treated with iron supplementation and proton pump inhibitors. DiscussionErythema ab igne appears as a reticulated, erythematous, hyperpigmented eruption that may occur after prolonged and repeated skin exposure to mild heat or infrared radiation, but under the threshold of thermal burn [1]. It can be also characterized by skin atrophy, telangiectasia and subepidermal bullae, and it is usually asymptomatic. Distribution and contour of the skin lesions depend on the direction of the incident radiation, and the interposition of clothing.

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“…peritoneal dialysis, may actually protect our far from 'ideal' patients from developing this severe, life-threatening condition ( table 1 ) [6,7,11,16,17] .…”

Section: Discussionmentioning

confidence: 99%

“…Kidney biopsy is oft en relatively contraindicated in the presence of small shrunken kidneys typical of vascular nephropathy, oft en coexistent with CCE. Th e skin lesions are protean, the yield is as low as 30-50% in the case of livedo reticularis, while skin biopsy is contraindicated in the case of necrotic lesions [6] .…”

Section: Introductionmentioning

confidence: 99%

Cholesterol Crystal Embolism Syndrome in Dialysis Patients: An Emerging Clinical Diagnosis?

Piccoli

Fenoglio²,

Colla³

et al. 2006

Blood Purif

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Background: Cholesterol crystal embolism syndrome (CCE) is an increasing end-stage renal disease cause. Few cases have been described on dialysis, despite the high prevalence of the predisposing factors. Methods: The diagnostic criteria of the present study were: skin lesions, myalgia, fatigue, fever and acute inflammatory serologic signs, in the presence of severe vasculopathy. The precipitating factors were: anticoagulation, endovascular intervention and ulcerated atherosclerotic plaque. Results: Between October 2003 and September 2005, CCE was diagnosed in 6 dialysis patients (of 200–210 on chronic treatment): 5 males, 1 female, median age 59.5 years (47–70) and end-stage renal disease follow-up 11.5 years (3–25). All had severe vasculopathy, 5 cardiopathy, and 4 were failed graft recipients. The treatment included: peritoneal dialysis, daily dialysis, ‘conventional’ hemodialysis (2 cases) and hemodiafiltration. The diagnosis was based on the clinical-laboratory picture in 1 patient. In the 5 others clues were present (dicumarol therapy, angioplasty, femoral artery thrombosis, CCE predialysis and ulcerated aortic plaque). The therapeutic approach consisted of corticosteroids (5 cases), statins (4 cases) and prostaglandin analogues (4 cases). Conclusion: The differential diagnosis of CCE should also be considered in dialysis patients (necrotic lesions, limb pain and vasculitis-like signs).

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Livedo reticularis: An update

Cited by 120 publications

References 89 publications

ESVM guidelines – the diagnosis and management of Raynaud’s phenomenon

ESVM guidelines – the diagnosis and management of Raynaud’s phenomenon

Erythema ab igne

Cholesterol Crystal Embolism Syndrome in Dialysis Patients: An Emerging Clinical Diagnosis?

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