🩺 FREE MSRA PODCAST – Livedo Reticularis: The Clue Beneath the Skin
Get the high-yield facts on livedo reticularis: the net-like, purplish skin pattern that can be a signpost to something much deeper. Perfect for your MSRA revision.

Key Learning Points

🔎 Definition
• Livedo reticularis is a vascular pattern: mottled, net-like purplish discolouration of the skin
• Most visible on limbs, worsens with cold

⚖️ Causes
• Primary (idiopathic): Benign, no underlying disease
• Secondary: Linked to serious conditions (systemic lupus erythematosus, antiphospholipid syndrome, polyarteritis nodosa, cryoglobulinaemia, vasculitis, medications, cold, clotting disorders)

🧬 Pathophysiology
• Arteriolar constriction/sluggish blood flow leads to deoxygenated blood pooling in superficial venules
• Can be due to vessel spasm, inflammation, clots, or abnormal proteins blocking flow

🩺 Clinical Features
• Lace-like, purplish (sometimes reddish-blue) network on skin
• Symmetrical, most common on legs and arms
• Pattern accentuated by cold; may fade with warmth
• No pain/itch unless underlying disease

🧠 Mnemonic: “NET CLASP” for Causes
N: None (idiopathic)
E: Endocrine/autoimmune (SLE)
T: Thrombotic (APS)
C: Cold
L: Lupus/vasculitis
A: Antiphospholipid syndrome
S: Systemic diseases
P: Polyarteritis nodosa/Proteins (cryoglobulinaemia)

🧪 Differential Diagnoses
• Cutis marmorata (transient in infants)
• Acrocyanosis (bluish extremities, no net pattern)
• Livedoid vasculopathy (painful, ulcerative)
• Embolic phenomena (acute, localised changes)

🔬 Diagnosis
• Clinical examination of skin pattern
• Investigate for secondary causes if red flags: full blood count, autoantibodies (ANA, anti-dsDNA), clotting screen, inflammatory markers
• Skin biopsy if uncertain or systemic disease suspected

💊 Management
• Primary: Reassure, keep warm, protect from cold
• Secondary: Treat underlying cause—immunosuppression (e.g., for lupus/vasculitis), anticoagulation (for APS), supportive care
• Regular follow-up for systemic disease

⚠️ Complications
• Primary: Benign, cosmetic only
• Secondary: Depends on underlying condition—risk of ulceration, tissue damage, stroke or thrombosis (in APS), organ involvement (vasculitis, lupus)

📚 MSRA Revision Resources for Livedo Reticularis
📝 Revision Notes: https://www.passthemsra.com/topic/livedo-reticularis-revision-notes/
💬 Flashcards: https://www.passthemsra.com/topic/livedo-reticularis-flashcards/
🧠 Accordion Q&A: https://www.passthemsra.com/topic/livedo-reticularis-accordion-qa-notes/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/livedo-reticularis-rapid-quiz/
🧪 Full Quiz: https://www.passthemsra.com/quizzes/livedo-reticularis/
🎓 Dermatology Course: https://www.passthemsra.com/courses/dermatology-for-the-msra/

🌐 For more free & premium revision resources:
https://www.passthemsra.com

#MSRA #LivedoReticularis #MSRARevision #DermatologyMSRA #Autoimmune #APS #Lupus #Vasculitis #PassTheMSRA #FreeMSRA #MSRAFlashcards