Livedo reticularis (LR) is a skin condition that often reflects what may be happening inside the body. It appears as a purplish, lace-like discoloration on the skin, commonly on the legs, arms, or trunk. Though the pattern may look concerning, LR isn’t always dangerous. In many cases, it’s harmless and temporary. However, when persistent, it may be associated with systemic conditions that require medical evaluation.
The skin pattern in LR results from disrupted or uneven blood flow in small vessels, leading to a pooling of deoxygenated blood. It becomes more visible in cold weather and may fade when the skin warms up. There are two forms: primary (physiological) LR, which is benign and cold-induced, and secondary (pathological) LR, which is linked to diseases like autoimmune disorders or vascular issues.
Common causes of LR include cold exposure, which is harmless, and more serious conditions like vasculitis, blood clotting disorders, or autoimmune diseases such as lupus or antiphospholipid syndrome. Certain medications can also trigger the condition. Rarely, LR may be linked with severe illnesses such as Sneddon’s syndrome or cholesterol embolization, making medical assessment important in persistent cases.
Symptoms vary depending on the cause. While the main sign is the net-like skin discoloration, some people may also experience numbness, pain, ulcers, or even neurological symptoms like headaches or stroke if the condition is tied to systemic disease. Temporary discoloration that disappears with warmth is usually not a concern.
Diagnosis involves a physical exam, patient history, and possibly blood tests, skin biopsy, or imaging to assess vascular health. Treatment is based on the type: primary LR often needs no treatment, while secondary LR requires addressing the underlying condition.
Seeing a doctor is important if the discoloration is persistent, painful, or accompanied by other symptoms. While LR is often benign, early detection of secondary causes can prevent serious complications and improve long-term outcomes.