What are the other Names for this Condition? (Also known as/Synonyms)

• Livedo Redicularic of Unknown Cause
• Primary Livedo Reticularis

What is Idiopathic Livedo Reticularis? (Definition/Background Information)

• There are three types of Livedo Reticularis, a condition that causes mesh-like purple skin patterns. Among these, one is Primary Livedo Reticularis and the other is Secondary Livedo Reticularis. Both these conditions have similar clinical findings
• However, the most common of them all is Physiologic Livedo Reticularis. This form is common in newborns, infants, and children. It appears in a cold environment and resolves on warming. Physiologic Livedo Reticularis also occurs in adults. In this population, it can be associated with other vascular findings which are not caused by a definable disease
• Primary Livedo Reticularis is also known as Idiopathic Livedo Reticularis when the cause of the condition is unknown. When Livedo Reticularis occurs secondary to an identifiable cause, it is called Secondary Livedo Reticularis
• Idiopathic Livedo Reticularis is a common skin condition in which the skin of the lower legs has a lace-like pattern, because of the dilatation of medium-sized blood vessels under the skin. The lace or mesh like pattern can also occur on the arms, chest, and back
• The enlargement of the blood vessels results in sluggish venous blood flow. Venous blood is low in oxygen, and hence, it gives a bluish hue to the affected skin
• Idiopathic Livedo Reticularis is a benign condition that gets worse during winters. There is no particular treatment for the condition; nevertheless, the prognosis is generally excellent

Who gets Idiopathic Livedo Reticularis? (Age and Sex Distribution)

Young to middle-aged women are more prone to Idiopathic Livedo Reticularis.

What are the Risk Factors for Idiopathic Livedo Reticularis? (Predisposing Factors)

• The main risk factor associated with Livedo Reticularis is cold temperature, such as occurring during the winter season

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Idiopathic Livedo Reticularis? (Etiology)

The cause of Idiopathic Livedo Reticularis is presently unknown.

What are the Signs and Symptoms of Idiopathic Livedo Reticularis?

The signs and symptoms associated with Idiopathic Livedo Reticularis may include:

• Discoloration of the skin, seen as a red-bluish tan in a lace-like (reticulated) pattern
• The affected skin may show loss of sensation with occasional ulcerations, especially when exposed to cold temperatures
•  Involvement of the body parts that are exposed to cold such as the arms and legs
• The reticular pattern may not disappear even on warming the affected area

How is Idiopathic Livedo Reticularis Diagnosed?

Idiopathic Livedo Reticularis can be diagnosed by:

• A thorough physical examination along with a clinical history evaluation by the healthcare provider
• Skin biopsy: A small tissue sample is sent to the laboratory for histopathological examination by a pathologist. To effectively evaluate some of the vascular diseases causing Secondary Livedo Reticularis, the tissue sample provided by biopsy may need to be larger than usual. The pathologist examines the sample under a microscope and arrives at a definitive diagnosis
• Before the diagnosis of Idiopathic Livedo Reticularis can be made, the pathologic, disease associated causes of Secondary Livedo Reticularis need to be excluded. Besides a skin biopsy, the medical history taken may need to be extensive, and multiple blood tests may also be required

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Idiopathic Livedo Reticularis?

Idiopathic Livedo Reticularis may result in the following complications:

• The affected skin may ulcerate which may cause skin infections
• Loss of sensation in the affected region
• Permanent discoloration of skin due to permanent dilatation of the blood vessels. If the discoloration is significant, it can cause psychological stress due to cosmetic issues

How is Idiopathic Livedo Reticularis Treated?

There is no specific treatment for Idiopathic Livedo Reticularis.

• Warming of the affected areas can be attempted
• Occasionally, medications such as pentoxifylline or low molecular weight heparin may be prescribed

How can Idiopathic Livedo Reticularis be Prevented?

Idiopathic Livedo Reticularis is a skin disorder of unknown origin. Presently, it cannot be prevented.

What is the Prognosis of Idiopathic Livedo Reticularis? (Outcomes/Resolutions)

Idiopathic Livedo Reticularis is a completely benign condition of unknown cause. It may disappear without treatment. The prognosis is generally excellent.

Additional and Relevant Useful Information for Idiopathic Livedo Reticularis:

There are many other clinical conditions that are associated with Livedo Reticularis.

• Cutis marmorata telangiectatica congenital: It is a form of Livedo Reticularis. It usually occurs in newborn babies. It is generally seen as a part of other genetic abnormalities such as long or short arms and legs, increased pressure in the eyes (called glaucoma) and macrocephaly (large head)
• Physiologic Livedo Reticularis, also known as cutis marmorata: It is a clinical condition wherein Livedo Reticularis occurs when exposed to cold. This is a physiologic type of Livedo Reticularis and it occurs all over the body in a diffuse manner. The condition occurs in newborns and in adults too. It is not considered as an illness, but only a response of the body to the cold. Cutis marmorata disappears after a short period of time and no treatment is necessary
• Sneddon's syndrome: It is a clinical condition with a vascular network pattern subtly different from  Livedo Reticularis. In this condition, the individual will have additional symptoms that are related to the neurological, eye, and cardiovascular systems. The symptoms may include headaches, disorientation, difficulty in balance, and other conditions.  

There are numerous causes of Secondary Livedo Reticularis. These include vitamin deficiencies, autoimmune disorders, (such as SLE, polyarthritis nodosa, and RA), variety of medications, malignancies such as lymphomas, infections such as tuberculosis, blood-clotting disorders such as antiphospholipid syndrome, polycythemia vera, thrombocytosis, cryoglobulinemia, connective tissue disorders, etc.