Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android. Learn more here!

For further information, see CMDT Part 20-29: Livedo Reticularis & Livedo Racemosa

Key Features

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

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 distribution (often found on trunk and buttocks as well as extremities)

  • Lesions are more irregular, broken, and circular

  • Presenting manifestation of 25% of patients with antiphospholipid antibody syndrome

  • Other underlying causes include

    • 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


  • Clinical


  • Protection from exposure to cold

  • Vasodilators seldom indicated

  • If ulcerations or gangrene, exclude an underlying systemic disease

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.