Livedo Reticularis as a Criterion for Antiphospholipid Syndrome

Abstract

Many consensus meetings were organized in an attempt to improve the present criteria for antiphospholipid syndrome (APS) classification. In this regard, a high prevalence of antiphospholipid antibodies in systemic lupus erythematosus patients was reported in association with the presence of livedo reticularis (LR). In these studies, the association between LR, migraine, and the development of thrombosis (strokes, valvular dysfunctions) was evident. During the last decade, it was strongly suggested that many clinical symptoms (LR, valvular dysfunctions) or laboratory features (thrombocytopenia) should be considered as "minor criteria" for APS. The inclusion of these clinical symptoms in the criteria for APS classification could become of additive value especially when they exist together in one patient. This review summarizes the data that question or support this idea.

Vitamin D: an instrumental factor in the anti-phospholipid syndrome by inhibition of tissue factor expression

“…An inverse correlation between vitamin D levels and thrombosis was observed in our cohort. Interestingly, most other manifestations that were found to be related to vitamin D deficiency in this study (such as pulmonary hypertension, livedo reticularis, skin ulceration and certain neurological events) may also be attributed to the existing coagulopathy of APS 32. This link between vitamin D and thrombosis was previously reported in other conditions.…”

Cutaneous manifestations of antiphospholipid syndrome

“…16 LR is defined as the persistent, not reversible with rewarming, violaceous, red or blue, reticular or mottled. 10 Regular LR consists on regular unbroken circles) 18 (Figure 1). The reticular branch width is classified into a fine or large pattern (≤ or > 10 mm, respectively).…”

Pathogenic Mechanisms of Thrombosis in Antiphospholipid Syndrome (APS)

“…Livedo reticularis is caused by stagnation of blood in dilated superficial capillary venules and its prevalence in APS is calculated at 24%, according to the study of Cervera et al [ 43,44 ]. This lesion represents the first manifestation of the syndrome in 17-40% of patients.…”