Livedo Reticularis Lupus

Livedo Reticularis Lupus. Livedo reticularis is characterized by a reticular reddishblue discoloration of the skin which blanches on pressure and is independent of temperature changes The designation “symptomatica&#39&#39 denotes the association of the lesion with another disease The livedo reticularis remained constant in this patient and was not influenced by changes in the associated systemic lupus erythematosus Author Richard L GoldenCited by Publish Year 1963.

CauseDiagnosisPreventionTreatmentSymptomsSigns and symptomsRisksPrognosisThree forms of specific skin disease occur in people with lupus and it is possible to have lesions of multiple types In addition a person can also have one of the three forms outlined below without actually having fullblown systemic lupus erythematosus (SLE) but the presence of one of these disease forms may increase a persons risk of developing SLE later in life Usually a skin biopsy is used to diagnose forms of cutaneous lupus and various medications are available for treatment including steroid ointments corticosteroids (eg prednisone) and antimalarials (eg Plaquenil) Approximately onethird of all people with lupus experience a condition called Raynauds phenomenon in which the blood vessels supplying the fingers and toes constrict The digits of people with Raynauds are especially susceptible to cold temperatures Often people with the condition will experience a blanching (loss of color) in the digits followed by blue then red discoloration in temperatures that would only be mildly uncomfortable to other people (such as a highly airconditioned room) It is very important that people with Raynauds wear gloves and socks when in airconditioned spaces or outside in cool weather Hand warmers used for winter sports (eg Hot Hands) can also be purchased and kept in your pockets to keep your hands warm These measures are very important since Raynauds phenomenon can cause ulceration and even tissue death of the fingers and toes if precautions are not taken People have even lost the ends of their fingers and toes due to the poor circulation involved in Raynauds phenomenon Cigarettes and caffeine can exacerbate the effects of Raynauds so be sure to avoid these substances If needed your doctor may also recommend a calcium channel blocker medication such as nifedipine or amlodipine to help dilate your blood vessels Chronic cutaneous (discoid) lupus erythematosus is usually diagnosed when someone exhibits signs of lupus in the skin People with SLE can also have discoid lesions and about 5% of all people with DLE will develop SLE later in life A skin biopsy is used to diagnose this condition and the lesions have a characteristic pattern known to clinicians they are thick and scaly plug the hair follicles appear usually on surfaces of the skin exposed to sun (but can occur in nonexposed areas) tend to scar and usually do not itch If you are diagnosed with discoid lupus you should try to avoid sun exposure when possible and wear sunscreen with Helioplex and an SPF of 70 or higher In addition you doctor may prescribe medications to help prevent and curb inflammation including steroid ointments pills or injections antimalarial medications such as Plaquenil and/or immunosuppressive medications 50% of all people with lupus experience sensitivity to sunlight and other sources of UV radiation including artificial lighting For many people sun exposure causes exaggerated sunburnlike reactions and skin rashes yet sunlight can precipitate lupus flares involving other parts of the body For this reason sun protection is very important for people with lupus Since both UVA and UVB rays are known to cause activation of lupus patients should wear sunscreen containing Helioplex and an SPF of 70 or higher Sunscreen should be applied everywhere including areas of your skin covered by clothing since most clothing items contain an SPF of only about 5 Be sure to reapply as directed on the bottle since sweat and prolonged exposure can cause coverage to dissipate About 10% of lupus patients have SCLE The lesions characteristic of this condition usually do not scar do not appear thick and scaly and usually do not itch About half of all people with SCLE will also fulfill the criteria for systemic lupus Treatment can be tricky because SCLE lesions often resist treatments with steroid creams and antimalarials People with SCLE should be sure to put on sunscreen and protective clothing when going outdoors in order to avoid sun exposure which may trigger the development of more lesions About half of all lupus patients experience a characteristic rash called the malar or butterfly rash that may occur spontaneously or after exposure to the sun This rash is sonamed because it resembles a butterfly spanning the width of the face and covering both cheeks and the bridge of the nose The malar rash appears red elevated and sometimes scaly and can be distinguished from other rashes because it spares the nasal folds (the spaces just under each side of your nose) The butterfly rash may appear on its own but some people observe that the appearance of the malar rash indicates an oncoming disease flare Whatever the case it is important to pay attention to your bodys signals and notify your physician of anything unusual People with lupus may experience a lacy pattern under the skin called livedo reticularis This pattern may range anywhere from a violet web just under the surface of the skin to something that looks like a reddish stain Livedo can also be seen in babies and young women is more prominent on the extremities and is often accentuated by cold exposure The presence of livedo is usually not a cause for alarm but it can be associated with antiphospholipid antibodies About 25% of people with lupus experience lesions that affect the mouth nose and sometimes even the eyes These lesions may feel like small ulcers or canker sores Such sores are not dangerous but can be uncomfortable if not treated If you experience these types of lesions your doctor may give you special mouthwash or Kenalog in Orabase (triamcinolone dental paste) to help expedite the healing process About 10% of all people with lupus will experience hives (urticaria) These lesions usually itch and even though people often experience hives due to allergic reactions hives lasting more than 24 hours are likely due to lupus If you experience this condition be sure to speak with your doctor since s/he will want to be sure that the lesions are not caused by some other underlying condition such as vasculitis or a reaction to medication Your doctor will probably distinguish these lesions from those caused by vasculitis by touching them to see if they blanch (turn white).

LupusSpecific Skin Disease and Skin Problems : Johns Hopkins

Last Updated on Sat 12 Dec 2020 | Lupus Erythematosus In recent years it has been recognized that livedo reticularis is the manifestation of the presence of antiphospholipid antibodies in patients with SLE [ (secondary antiphospholipid syndrome (APS)] One study indicates that 17% of 66 patients with SLE demonstrated the presence of livedo reticularis and that 81% of these patients demonstrated the presence of antiphospholipid antibodies (Yasue 1986).

Livedo reticularis in a patient with systemic lupus

A significant positive correlation exists between livedo reticularis and elevated serum antiphospholipid activity in patients with systemic lupus erythematosus aCL are shown to play a possible pathogenetic role in thrombotic events This suggests that thrombosis is the underlying cause of livedo in these patients Author A Genovese G Spadaro G MaronePublish Year 1993.