Livedoid vasculitis

Infobox_Disease
Name = Livedoid vasculitis


Caption =
DiseasesDB = 7546
ICD10 = ICD10|L|95|0|l|80
ICD9 = ICD9|xxx
ICDO =
OMIM =
MedlinePlus = 001478
eMedicineSubj = derm
eMedicineTopic = 39
MeshID =

Livedoid vasculitis (also known as "livedo vasculitis", livedo reticularis, and "livedoid vasculopathy") is a vascular disorder mostly affecting women. Typically, it involves a lace-like purplish discoloration of the lower extremities. The condition may be normal or may be related to more severe underlying pathology. It may be aggravated by exposure to cold and occurs most often in the lower extremities. It can also be associated with the presence of anti-cardiolipin antibodies (the Antiphospholipid syndrome).

The condition's name derives from the Latin "livere" meaning bluish.

Etiology

A number of conditions may cause the appearance of livedo reticularis:
* Cutis marmorata telangiectatica congenita a rare congenital condition
* Sneddon syndrome - association of Livedoid vasculitis and systemic vascular disorders, such as strokes, due to underlying genetic cause. [cite journal |author=Sneddon I |title=Cerebro-Vascular Lesions And Livedo Reticularis |journal=Br J Dermatol |volume=77 |issue= |pages=180–5 |year=1965 | month=Apr |pmid=14278790 |doi=10.1111/j.1365-2133.1965.tb14628.x]
* Idiopathic livedo reticularis - the most common form of livedo reticularis and is a completely benign condition of unknown cause affecting mostly young women during the winter. [cite journal |author=Gibbs M, English J, Zirwas M |title=Livedo reticularis: an update |journal=J Am Acad Dermatol |volume=52 |issue=6 |pages=1009–19 |year=2005 |pmid=15928620 |doi=10.1016/j.jaad.2004.11.051] It is a lacy purple appearance of skin in extremities due to sluggish venous blood flow. May be mild, but ulceration may occur later in the summer. [cite journal |author=Feldaker M, Hines E, Kierland R |title=Livedo reticularis with summer ulcerations |journal=AMA Arch Derm |volume=72 |issue=1 |pages=31–42 |year=1955 |pmid=14387292]
* Secondary livedo reticularis:
** Vasculitis autoimmune conditions:
*** Livedoid vasculitis - with painful ulceration occurring in the lower legs
*** Polyarteritis nodosa
*** Systemic lupus erythematosus [cite journal |author=Golden R |title=Livedo reticularis in systemic lupus erythematosus |journal=Arch Dermatol |volume=87 |issue= |pages=299–301 |year=1963 | month=Mar |pmid=13948706]
*** Dermatomyositis
*** Rheumatoid arthritis
*** Lymphoma
*** Pancreatitis [cite journal |author=Sigmund W, Shelley W |title=Cutaneous manifestations of acute pancreatitis, with special reference to livedo reticularis |journal=N Engl J Med |volume=251 |issue=21 |pages=851–3 |year=1954 |pmid=13214346]
*** Tuberculosis
*** Amantadine (drug)
** Obstruction of capillaries:
*** Cryoglobulinaemia - proteins in the blood that clump together in cold conditions. [cite journal |author=Langhof H, Braun G, Matzkowski H |title= [Livedo reticularis due to cold gelation of the blood by gamma-plasmacytoma.] |journal=Arch Klin Exp Dermatol |volume=205 |issue=4 |pages=343–50 |year=1957 |pmid=13522017]
*** Antiphospholipid syndrome due to small blood clots
*** Hypercalcaemia (raised blood calcium levels which may be deposited in the capillaries)
*** Haematological disorders of Polycythaemia rubra vera or Thrombocytosis (excessive red cells or platelets)
*** Infections (syphilis and tuberculosis)
*** Arteriosclerosis (cholesterol emboli) [cite journal |author=Kazmier F, Sheps S, Bernatz P, Sayre G |title=Livedo reticularis and digital infarcts: a syndrome due to cholesterol emboli arising from atheromatous abdominal aortic aneurysms |journal=Vasc Dis |volume=3 |issue=1 |pages=12–24 |year=1966 |pmid=5903590] [cite journal |author=Stewart W, Lauret P, Testart J, Thomine E, Boulliê M, Leroy D |title= [Cutaneous cholesterol emboli (author's transl)] |journal=Ann Dermatol Venereol |volume=104 |issue=1 |pages=5–8 |year=1977 | pmid= 843026] and homocystinuria (due to Chromosome 21 autosomal recessive Cystathionine beta synthase deficiency)
*** Intra-arterial injection (especially in drug addicts)

Treatment

Other than identifying and treating any underlying conditions in secondary livedo, [cite journal |author=Fleischer A, Resnick S |title=Livedo reticularis |journal=Dermatol Clin |volume=8 |issue=2 |pages=347–54 |year=1990 |pmid=2191805] idiopathic livedo reticularis itself may improve with warming the legs, but once established the skin discolouration may become permanent.

Footnotes

External links

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