Livedo reticularis- how to treat this?
A 69-year-old female with a past medical history of cutaneous squamous cell carcinoma, hypertension, anxiety, depression, and acid reflux presented to the dermatology clinic for a routine full body skin exam. On exam, red-purple patches and connecting rings in a lace-like pattern were noted on her bilateral upper and lower extremities. The findings were consistent with LR. The patient revealed that these lesions had been present since birth. She noted they worsen in cold temperatures and improve in warm temperatures but are always present and never completely resolve. The patient denied any associated symptoms including pain and tenderness. Family history revealed the patient’s sister and mother have persistent LR as well. Review of systems was unremarkable. Current medications included lisinopril, pantoprazole, venlafaxine, and alprazolam. She denied history of autoimmune disease, significant malignancy, or infectious disease
@rajan Livedo reticularis (LR) describes a cutaneous vascular pattern that presents in a reticular or net-like configuration. The resulting mottled, reddish-blue to purple discoloration of skin is due to an accumulation of deoxygenated blood. Decreased blood flow to the skin or decreased drainage from the skin results in an increase in deoxygenated blood trapped in the cutaneous venous plexus. While this reaction is most commonly seen as a benign response to cold-induced vasospasm, known as cutis marmorata, LR can also be associated with congenital disease and systemic disorders that alter blood flow. Therefore, LR can serve as an indicator of underlying disease, and these diseases should be considered with persistent LR.