LIVEDO RETICULARIS: CLINICAL SIGNIFICANCE AND TREATMENT

Abstract

Livedo reticularis (LR) is a hyperpigmented discoloration of the skin characterized by a violet, reticulated cyanotic pattern, and is more common on the extremities and trunk. LR is in the form of intact circular networks. If the circular reticulated appearance is distorted and shows an irregular fracture pattern, it is defined as livedo racemosa (LRC). LR is a benign, primary disease that affects young and middle-aged women. LRC, on the other hand, is a secondary disease, pathological and permanent. In LR, the vivid cone discoloration is symmetrical, reversible, and uniform. In LRC, the vivid cone discoloration is irreversible, and fractured. Although it has been stated as a concept that the pathological livedoid form is LCR, there is no clear distinction between LR and LRC in clinical studies and generally 'livedo reticularis' is used to describe both. Our study includes eight patients diagnosed with livedo reticularis between January 2013 and May 2021. One of our patients was male and the other was female. Their ages ranged from 25 to 70 years and the mean age was 45.5±16.7 years. Although the main complaints were coldness, numbness and pain, aesthetic anxiety was prominent in all patients. On physical examination, violet-colored fishing net-like appearances were noted on the lower extremities of all patients. It was accompanied by venous insufficiency in six of the patients. As a result of the treatment we applied, there was improvement in venous insufficiency. However, as a result of the vasodilator treatment we applied for cosmological purposes, there was no obvious improvement in the reticulated appearances. Because of the risk of developing neurovascular and cardiovascular complications several years after the onset of livedoid vasculopathy, it is important to monitor these patients. Considering that LR may be seen before pulmonary symptoms during the COVID-19 pandemic period, necessary tests should be performed to rule out the diagnosis of COVID-19 in these cases.