Livedo reticularis is a condition characterized by typical net like blotchy reddish blue to purple net like pattern on skin. Livedo reticularis is of two types; primary or idiopathic and secondary. The symptoms of both these types are similar. The term livedo was first used by Hebra more than a century ago. He described the violet blotchy skin pattern on skin to be caused due to dilatation of cutaneous blood vessels and stagnation of blood within it.
Livedo reticularis is said to be idiopathic when its cause is not known. In secondary livedo reticularis the underlying cause is known, such as hypercoagulable syndrome, cardiac failure, thyroid disorder etc.Idiopathic livedo reticularis mainly develops on legs but sometime it can also affect other areas of body such as the arm, and trunk.
Exposure to cold winter is the major risk factor in development of this skin pattern. Treatment consists of applying warmth to the affected area and avoidance of cold climate. It can help to diminish its appearance.
What Causes Idiopathic Livedo Reticularis?
The exact cause of idiopathic livedo reticularis is not known. It is more commonly observed in young and middle aged females, although the purplish net like skin pattern is also observed in males.Livedo reticularis occurs when there is transient or constant dilatation of capillaries underneath the skin. Capillaries are tiny blood vessels.
Dilatation leads to stagnation or sluggish flow of blood in the vessels and underneath the skin. Reduced blood flow due to dilatation and low oxygen level in stagnated blood gives typical bluish purple appearance. The most prominent and the only risk factor known to cause this condition is cold temperature. Exposure to cold during winter is one of the risk factors for its development.
Signs And Symptoms Of Livedo Reticularis
Clinically idiopathic livedo reticularis appears as follows:
- Appearance of red to blue or purple discoloration in netted or lace like pattern on skin surface.
- The center of discolored area is pale.
- The discolored area appears mottled.
- The affected area of skin has reduced sensation. There is occasional ulceration on skin surface if exposed to extreme cold climate.
- The condition is pronounced or becomes prominent during winter months or when the skin area remains exposed to severe cold temperature.
- The net like pattern of unbroken circles usually develop in legs. Sometimes it may also affect arms and chest.
Complications And Treatment Of Livedo Reticularis
Following are some of the complications that may develop in idiopathic livedo reticularis.
- Development of ulcers on the skin surface.
- Prone to skin infection once ulcers develop.
- There is reduced sensation on mottled skin surface.
- Persistent formation of the discolored patch with net like formation of dilatation of capillaries. Although benign the appearance on skin may be cosmetic concern. This may produce increased stress and anxiety in the patient. Especially the patient in most cases is female.
Idiopathic livedo reticularis is not harmful skin disease. Researchers are unable to pin point specific treatment measure. However, a person suffering from this skin condition must avoid cold exposure to the affected area of skin. Some patients are concerned due to cosmetic reasons. The dermatologist in such situation may start vasodilator therapy.
Applying hot fomentation during cold climate will alleviate symptoms. Conservative measures such as keeping the leg slightly elevated during sleep and using compression stocking will be helpful to get symptomatic relief. Usually the condition may disappear even without treatment.