Los anillos violaceos que configuran la livedo reticularis
son causados por una disminucion del flujo sanguineo periferico, focal y persistente, con enlentecimiento de la circulacion ve nosa cutanea por oclusion de las arteriolas de la dermis.
Key words: Sneddon's Syndrome, generalized livedo reticularis
, cerebrovascular lesion, autoantibodies
APA-associated cardiac valve disease APA-associated livedo reticularis
APA-associated nephropathy APA-associated thrombocytopenia Other skin manifestions Ulcerations, pseudo-vasculitic lesions, digital gangrene, superficial phlebitis, malignant atrophic papulosis-like lesions, subungual splinter hemorrhages, and anetoderma (a circumscribed area of loss of dermal elastic tissue) Other neurological manifestations Cognitive dysfunction, chorea, headache or migraine, multiple sclerosis, transverse myelopathy, and epilepsy Table 4.
5) Skin involvement occurred in 35% of these patients including livedo reticularis
, gangrene and cyanotic toes.
Mucocutaneous Findings in Children, Youth Finding Percentage Fissured tongue 28 Hypertrophy of tongue papillae 22 Premature graying 14 Cheilitis 13 Xerosis 12 Alopecia areata (including 1 child with alopecia totalis) 11 Palmoplantar hyperkeratosis 10 Syringoma 6 Keratosis pilaris 4 Geographic tongue 4 Trichotillomania (3 girls and 1 boy) 4 Vitiligo 3 Seborrheic dermatitis 3 Livedo reticularis
2 Atopic dermatitis 0 Source: Dr.
The dermatologic conditions included livedo reticularis
, skin ulcerations, pseudovasculitis lesions, superficial skin necrosis, digital gangrenes, superficial phlebitis, multiple subungual splinter hemorrhages, and anetoderma.
An erythematous livedo reticularis
rash was noted on both thighs.
Calciphylaxis generally manifests with tender, violet-colored or erythematous, mottled skin lesions, known as livedo reticularis
(Angelis et al.
These ischemic changes lead to livedo reticularis
, painful violaceous plaquelike subcutaneous nodules, or both.
Features of APS include hemolytic anemia, thrombocytopenia, venous and arterial occlusions, livedo reticularis
, pulmonary manifestations, recurrent fetal loss, neurologic manifestations (stroke, transverse myelitis, Guillain-Barre syndrome); and a positive Coombs test, anticardiolipin antibodies, or lupus anticoagulant activity (1).
Adverse effects occur in fewer than 10% of patients; they include some anticholinergic effects, ankle edema and livedo reticularis
(purplish mottling of the skin, which resolves on discontinuation of the drug).
In contrast, patients with GPA most often had painful skin lesions (10%) or maculopapular rash (7%), while those with MPA were more likely to have livedo reticularis
or racemosa (7%).