I can get this at any time. Often a red pin prick dot will be in center of white balanced ring. Never itches.
This was last night at our pharmacy. Walgreens ( a sister company to England’s Boots.)
I believe it’s a component of livedo.
I’m trying to understand what is going on with my vascular system/ clotting/ auto immune. I’ve been doing it for 16 years- started in my pregnancy with our 16 year old son.
Does anyone else present with this And does your doctor have an accurate understanding of what this is? Is it clearly connected to the APS livedo?
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Livedo reticularis can be developed at any age. The usual affected sites are the arms, legs, trunk and rarely it also observable on the back. Following are the symptoms of livedo reticularis:
Purple or bluish red discoloration on the skin surface
Pale coloration at the central of the discoloured area.
The discolouration is not even; it is mottled
Pain is associated in some cases
Skin ulceration may develop which produce discomfort and pain; this is more prominent in lower limbs
Numbness
Increase of body temperature
Inning or burning sensation
‘Falling asleep’ condition may develop at the upper or lower limbs
The condition becomes worsen with chilled temperature
Causes of Livedo reticularis
The lacy appearance is plainly a result of an impaired blood circulation caused by thrombosis in capillaries and arterioles. The reddish blue discoloration is associated with several underlying pathological conditions that cause swelling of the venules. These include:
Sneddon syndrome
It is a non-inflammatory arteriopathy in which the mottled discoloration of the skin has a relation with cerebrovascular disease. In this condition, some hereditary factors can lead to systemic vascular diseases, including strokes.
Cutis marmorata telangiectatica congenital
This uncommon, sporadic congenital vascular anomaly often affects the blood vessels of the skin.
Idiopathic livedo reticularis
Unsteady flow of blood through the veins, particularly in young females, could occur for unknown reasons. However, the sudden network-patterned cutaneous discoloration is completely innocuous with mild episodes of ulceration on the breasts, abdomen, buttocks and thigh, caused by heat.
Polyarteritis nodosa
Self-destructive immune cells often attack the medium and small-sized arteries, resulting in a severe type of vasculitis.
Fibromyalgia
The lacy discoloration of the skin can also be attributed to fibromyalgia, a chronic disorder marked by musculoskeletal pain, fatigue and tenderness.
Livedoid vasculopathy
It is a chronic, recurrent, painful skin disorder that involves lower extremities and feet. The thrombotic condition is non-inflammatory in nature and oftentimes leads to ulceration in the legs.
Dermatomyositis
In adults and young children, this inflammatory disorder manifests into muscle weakness and a distinctive skin rash. Swelling of the blood vessels may give rise to a reticular cyanotic discoloration of the skin.
Antiphospholipid syndrome
It is a complicated condition in which the presence of antiphospholipid antibodies in the blood leads to excessive clotting and low platelet count. Formation of such clots may either cause brushing or a blotchy, purplish rash. The disorder has often been linked to morbidity in pregnancy.
Cryoglobulinaemia
The stagnation of blood in the arteries and venules is frequently caused by precipitation of cryoglobulins at low temperatures.
Homocystinuria
It is an impaired metabolism of the amino acid methionine, which results in deficiency of calcium in the body.
Arteriosclerosis/Cholesterol emboli
Dilation of capillaries and venules could also be associated with thickening and hardening of the arterial walls.
Ehlers-Danlos Syndrome
It encompasses a group of disorders in which mottled cutaneous discoloration, laxity and joint hypermobility are the common hallmarks of the syndrome.
Systemic lupus erythematosus
The mottled reticulated vascular pattern is common in lupus patients since it causes spasm of the dermal ascending arterioles.
Autonomic nerve damage
Physical trauma or injury may lead to autonomic neuropathy in some cases. One of the most common manifestations of this condition is the abnormal rate of blood flow through the small arteries and capillaries that results in a bluish, lace-like discoloration of the skin. Palmar erythema, a vascular disease of the palms, has a similar cause.
Livedo reticularis Treatment
Appropriate medical care can be initiated to the affected patients on the basis of the results acquired from the diagnostic tests and exams. The aetiology of the condition is instrumental for treatment. Idiopathic livedo reticularis is a self-limiting condition that could be controlled by keeping the legs warm with the aid of a heating pad. Asymptomatic form of the disorder may come and go without the knowledge of the patients. Drug-induced livedo reticularis requires immediate withdrawal in order to reduce the attacks. However, the net-like purplish discoloration of the skin could become a permanent problem if not treated in time. The dermatologic manifestation is itself not treatable unless doctors recognize the underlying disorders. Delayed treatment may cause complications like thrombocytosis and thrombohemorrhagic disorder. Patients with antiphopholipids can be administered low-dose aspirin and hydroxychloroquine. Plasmapheresis could be carried out for cryoglobulinaemia. Immunosuppressive drugs such as cyclophosphamide and azathiprine can be used to cure polyarteritis nodosa. Livedoid vasculopathy-affected individuals may receive anti-platelet agents, anticoagulants, pentoxifylline and phenformin. On the other hand, anti-inflammatory medications like corticosteroids are suitable for treating dermatomyositis. Healthcare professionals prescribe cholesterol drugs, beta-blockers, and ACE inhibitors for lowering blood pressure and controlling the heart rate. The frequent episodes of the cutaneous condition can be prevented by avoiding cold condition and strenuous exercises.
Elevated levels of blood calcium can reduce the flow of blood through the narrow capillaries and veins.
I do have the classic livedo on arms and legs. this is just not classic. I’m wondering if it’s also livedo, because it does not look like my “ classic livedo” which is picture perfect text book.
Yes, I do know the full name. I have been properly diagnosed with the proper full diagnosis of livedo reticularis.
Professor Hughes simply called it “livedo” with me so I assumed it was common ...I figured you would know what I meant.
I’m trying to ascertain the extent of the auto immune component versus the anti coagulant component because right now while I’m clotting to try to make the best decision I can about very aggressive auto immune suppression. I’m reclotting quite badly so im seeing if there is a tie here. My INR staying close to 4.0 by vein and I’m continuing to clot.
All the best to your husband! He couldn’t have a more qualified wife ... so sorry.
My doctors are following dr Hughes guidelines and clinic letter for me. They are doing RAPS trial protocol.
It seems a sub set of us fail traditional methods and need immuno suppression. ( we clot despite proper anti coagulation. Not a blood flow issue.) This is why I’m asking about more auto immune clues.
Unfortunately, autoimmunity is not well understood. I follow dedicated researchers at University College Hospital, London, into B cells etc. One researcher's son has joined his father in this research.
In Israel, a certain type of worm, seems to have a positive impact for certain patients with SLE. Prof. Yehuda Schoenfeld at Tel Hashomer has patients willing to digest it! I would wait until the secretions are turned into a drug. He explains this on YouTube!
There are no 2 patients exactly the same, even though we share similarities!
It can also make us feel many things: frustration, anxiety and depression are common and "normal" responses!
Thank you! I’m sure I’m feeling all these things... even enough to try worms! I do know of this professors work. He is interested in auto immune over reactions to vassinatiins . ( he is a proponent of vassinatiins- not to be misleading.)
Our son is on the autism spectrum ( unless they changed that again this week! Ha!) - with a very mild case of Asperger’s syndrome. And.. APS now. He’s 16. Very highly gifted- IQ.
So I find dr. Y Schofield ‘s interest on that very poignant.
Livedo reticularis is a livedo that looks a certain way, and not like your picture, so your picture isn't it, _but_ it is probably still _a_ livedo and probably the same underlying cause - at a guess, since you've been clotting venous, insufficient venous drainage from the extremity.
This is very likely (just one more not-a-doctor opinion) another symptom showing that your APS is not under control, and whether it looks "reticularis" doesn't matter, particularly as you say you have characteristic reticularis elsewhere anyway.
More info: The reason livedo reticularis looks the way it does, and the characteristic of net/lace appearance, is explained by the first diagram on this page: clinicalgate.com/other-vasc... That diagram is used elsewhere as well, and I've found it the most helpful in understanding what is (thought to be) behind livedo. I don't have it, but after so many vague questions from doctors about "do you get a rash (no not like that)" it took some research and pictures to convince myself.
By the way Ray, while I have a moment and it’s on my mind, because I’ve thought this often about you at random yet inconvenient times ( like while doing the shopping - it’s when I seem to have a quiet moment to think and process!) ...
I wanted to take a “ real” moment to thank you. I’ve noticed time and again on this forum with so many people you really do take the time to give well thought through answers, which means you take the time to genuinely listen.
Your acumen for procuring relevant papers are incredibly helpful- especially to me . My eye sight would never allow me to do this.
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