II. Pathophysiology

  1. Deoxygenated, stagnating blood in dermal, dilated capillary blood vessels

III. Signs

  1. Characteristics
    1. Recurrent purple, red or blue discoloration of the skin in a reticular, lacy, fishnet pattern
    2. Skin Ulceration may occur
  2. Distribution
    1. Lower extremities most commonly involved
    2. May also affect upper extremities and trunk
  3. Provocative
    1. Cold exposure
      1. Cutis Marmorata refers to idiopathic onset with cold
  4. Palliative
    1. Idiopathic types improve more with rewarming than secondary types

IV. Causes

  1. Idiopathic (Cutis Marmorata)
    1. Cold exposure onset and resolves with warming
    2. Benign, without underlying Vasculitis
  2. Secondary Livedo Reticularis
    1. Lupus erythematosus
    2. Rheumatoid Arthritis
    3. Cryoglobulinemia
    4. Lymphoma
    5. Polycythemia Vera
    6. Polyarteritis Nodosa

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