Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 20-29: Livedo Reticularis & Livedo Racemosa + Key Features Download Section PDF Listen +++ +++ Livedo reticularis ++ A benign condition that primarily affects the extremities Usually asymptomatic (apart from cosmetic concerns) Produces a mottled, purplish discoloration of the skin in a fishnet pattern with reticulated cyanotic areas surrounding paler central cores +++ Livedo racemosa ++ Formerly known as secondary livedo reticularis Occurs in association with diseases that cause vascular obstruction or inflammation + Clinical Findings Download Section PDF Listen +++ +++ Livedo reticularis ++ Spasm or obstruction of perpendicular arterioles combined with pooling of blood in surrounding venous plexuses Worsens with cold exposure Improves with warming Consider an underlying disease when Systemic symptoms are present Cutaneous ulcerations develop +++ Livedo racemosa ++ Resembles idiopathic livedo reticularis Has a wider skin distribution (including trunk, buttocks, and extremities) Lesions are more irregular, broken, and circular Presenting manifestation in 25% of patients with antiphospholipid antibody syndrome Other underlying causes include Antiphospholipid antibody positive Sneddon syndrome (livedo reticularis and cerebrovascular events) Vasculitides (particularly polyarteritis nodosa) Cholesterol emboli syndrome Thrombocythemia Cryoglobulinemia Cold agglutinin disease Primary hyperoxaluria (due to vascular deposits of calcium oxalate) Disseminated intravascular coagulation + Diagnosis Download Section PDF Listen +++ ++ Clinical + Treatment Download Section PDF Listen +++ ++ Protection from exposure to cold Vasodilators seldom indicated If ulcerations or gangrene, exclude an underlying systemic disease