Livedo reticularis due to multiple cholesterol emboli

Purple Toes and Livido Reticularis in a Patient With Cardiovascular Disease Taking Coumadin

“…This pattern, involving primarily the feet, the legs, and, to a lesser extent, the buttocks and the lower part of the back, may be seen in approximately 50% of patients diagnosed with multiple cho¬ lesterol emboli. 9 Recently, many reports support cholesterol emboli as one of major causes of livido reticularis in patients after anticoagulant therapy.1,5,6,8,10,11 In our case, livido reticu¬ laris developed about 3 weeks after initiation of coumadin therapy and it persisted with progressive worsening of pur¬ ple toes. The purple toes and livido reticularis in this case were probably due to cholesterol microembolization coming from the arteriosclerotic plaque in the abdominal aortic aneurysm.…”

Differential Diagnosis of Leg Ulcers

“…Atheroembolism (cholesterol embolism) is a disease of patients with severe atherosclerosis, typically of the aortofemoral system [26]. Fragments from ulcerated atheromatous plaques lead to embolism of peripheral vessels of the skin and organs (kidneys!).…”

Isolated splenic infarction following left cardiac catheterization: Case report and a review of the literature

“…His general state of manifestations, such as livedo reticularis caused by occlusion of vessels at the dermosubcutaneous junction [9] or as "purple toe syndrome" [lo], renal insufficiency [ 1,111, mesenteric ischemia, and intestinal necrosis with resultant abdominal angina, melena, rectal bleeding, and perforation [2,3], acute pancreatitis secondary to transabdominal angiography [4], brain and spinal cord damage [5,12], coronary artery occlusion [13], amaurosis fugax due to retinal artery occlusion [14], and adrenal gland lesion [5]. In the case report of Ong et al [6] at autopsy, areas of infarctions were found in the spleen, the pancreas, the right lobe of the liver, and both kidneys in the patient after the catheterization and left ventricu-…”