Livedo

Livedo - resistant bluish color uneven color of skin, resulting from transmission through the skin vessels with passive hyperemia.


Livedo racemosa

There are several types: 1) Livedo racemosa is the result of functional or anatomical changes of skin vessels, resulting from chronic infections (syphilis, tuberculosis) or intoxication. Characterized by the appearance on the skin of limbs persistent bluish color tree-net spots disappear when pressed. Subjective sensations there. In cold, wet weather the spots are identified sharper, often combined with acrocyanosis. Sometimes livedo may be a symptom of periarteritis nodosa; 2) Livedo reticularis a calore - reticulate erythema, occurs under the influence of external causes (hot compresses, heating pad); the color of the skin begins to brown as a result of deposits hemo-sideline; 3) Livedo reticularis a frigore is the result of individual sensitivity vessels to cold; appears as reticular pink-purple coloring on bloodless the skin, especially expressed on the extensor surfaces of the limbs during cooling of the body; when the air temperature increase these effects disappear; 4) Livedo lenticularis - net marbling skin of the lower legs - initial stage erythema Bazin (see Tuberculosis skin).
Treatment: massage, warm baths, diathermy, UV-radiation; with Livedo racemosa is the treatment of chronic infections, intoxications.

Livedo (from lat. lividus is bluish-grey - bluish, uneven color of skin mesh or tree of figure resulting from transmission through the skin vessels, due to passive hyperemia.
Clinical varieties. 1. Livedo reticularis [synonym: L. annularis, cutis marmorata (marble skin), L. marmorata, asphyxia reticularis] - unstable, pink-violet or pale bluish, limited or widespread, vanishing at a pressure spots in the form of a grid with oval-rounded loops or in the form of dense, merging, different size circles. In the centre of loops skin color paler than normal. Observed more often in girls and young women. Located symmetrically on the extensor surfaces often lower extremities, lateral surface of the body; not accompanied by any sensations. L. reticularis occurs usually due to long-lasting effect on the skin low temperature (L. reticularis a frigore) in functional insufficiency of blood vessels of the skin; morphological changes of vessels are not available. Occurs in childhood, in the period of sexual development increases, then weakens. Often combined with acrocyanosis, perniosis, hyperhidrosis, disorders of keratinization (keratosis pilaris).
There is a form livedo reticularis, caused by long influence of heat (L. reticularis a calore). In this form appear first, fleeting, and then persistent redness, leaving a net skin pigmentation,so - called the reticular dermatitis (cutis marmorata retinitis, A. Buschke).
2. Livedo racemosa (S. Ehrmann), a rare skin lesion, manifested persistent, various sizes tree branching cyanotic-red spots. These stains do not peel for several years remain unchanged and will not disappear from the heat. Rarely in the zone of L. racemosa emerge spontaneously necrosis of the skin, causing ulcerations. Occurs almost exclusively in women. Is located on the skin of the shoulders, hips, buttocks, less often on the skin of the trunk.
Histopathology: inflammation of the walls of the small arterioles and veins of the skin and subcutaneous tissue (intimal proliferation, which sometimes results in the obliteration of the lumen of the vessels, perivascular infiltration), swelling, fibrinoidnogo swelling of collagen fibers, later fibrosis of the dermis. In addition to the skin, appropriate vascular changes may develop in muscle tissue.
Etiology often remains outstanding. L. racemosa may develop in syphilis (often in the tertiary period and late congenital), tuberculosis, typhus, dysentery, malaria, rivertree, chronic intoxications (alcoholism), tumors, dysfunction of endocrine glands, systemic lupus erythematosus, polyarteritis the nodosa, dermatomyositis, indurativnyy erythema, atropinum the acrodermatitis. Predisposing conditions of development L. racemosa, apparently, are congenital or acquired, organic or functional disorders of the cardiovascular system, in particular the change in the tone of peripheral vessels (heart disease, low blood pressure, arteriosclerosis). From L. reticularis L. racemosa is persistent and spotted, not disappearing from the heat, often limited nature of damage to the skin. Roseolous of sifile under permission of L. racemosa different correct oval-rounded form of spots, their abundance, symmetry. It is necessary to differentiate L. racemosa from congenital limited and distributed essential telangiectasia (a kind of vascular nevus).
3. Livedo lenticularis - net marbling skin of the lower legs, the initial stage of erythema indurativnyy Bazin (see Tuberculosis skin). Histologically characterized by endopleural.
Treatment. Tonic - vitamins C, P, PP, calcium supplements, skin radiation suberythermal doses of ultraviolet rays, warm baths, diathermy, massage. When L. racemosa on the testimony conduct specific protevoepilepticescoe, TB treatment; in severe cases of unclear etiology some improvement can be achieved by the use of corticosteroids.