Livedo Racemosa: Clinical, Laboratory, and Histopathological Findings in 33 Patients
Carregando...
Citações na Scopus
13
Tipo de produção
article
Data de publicação
2021
Título da Revista
ISSN da Revista
Título do Volume
Editora
SAGE PUBLICATIONS INC
Autores
ECHAVARRIA, Alejandra Maria Jimenez
CRIADO, Paulo Ricardo
CARVALHO, Joselio Freire de
Citação
INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS, v.20, n.1, p.22-28, 2021
Resumo
Livedo racemosa is a cutaneous finding characterized by a persistent, erythematous, or violaceous discoloration of the skin, in a broken, branched, discontinuous, and irregular pattern. A retrospective review of 33 cases with clinical diagnosis of livedo racemosa over the past 6 years was evaluated in the dermatology department of a tertiary care hospital. We found predominance in Caucasian women (78.8%); age ranged from 8 to 81 years, with a mean age of 36 years. Livedo racemosa was described as generalized in 12 patients (36.4%), although the main localization was on lower limbs (42%). After laboratory testing and histopathological examinations, 12 patients (36.4%) were classified with idiopathic livedo racemosa; secondary diseases were diagnosis in 21 patients (63.6%), including Sneddon's syndrome, cutaneous polyarteritis nodosa, systemic lupus erythematosus, and others. Medical history of thrombotic events was described in 8 (24.2%) patients, and also 8 (24.2%) patients had abnormal results for 2 or more thrombophilia laboratory tests. Skin biopsy showed no histological abnormalities in 11 cases (33.3%), thrombosis of dermal blood vessels in 10 (30.3%), intimal/subintimal thickening in 7 (21.2%), and vasculitis in 5 (15.2%). In conclusion, livedo racemosa is a clinical feature that might be correlated to vascular disorders, such as thrombotic and/or hypercoagulable states, autoimmune diseases, and neoplastic diseases, or it can be secondary to specific medications. It is essential to establish a correct approach in cases of livedo racemosa, which includes anamnesis, physical examination, laboratory test, histological examination, and complementary examination according to clinical findings, in order to diagnosis underlying causes.
Palavras-chave
antiphospholipid syndrome, livedo racemosa, lupus erythematosus, Sneddon's syndrome, thrombophilia, thrombosis, thrombotic events, cutaneous polyarteritis nodosa
Referências
- Criado PR, 2016, INT J LOW EXTR WOUND, V15, P78, DOI 10.1177/1534734615603566
- Herrero C, 2008, ACTAS DERMO-SIFILOGR, V99, P598
- Kawakami T, 2011, MEDICINE, V90, P119, DOI 10.1097/MD.0b013e3182115508
- Kraemer M, 2005, J NEUROL, V252, P1155, DOI 10.1007/s00415-005-0967-9
- Legierse CM, 2008, EUR J DERMATOL, V18, P322, DOI 10.1684/ejd.2008.0397
- Parsi K, 2011, AUSTRALAS J DERMATOL, V52, P237, DOI 10.1111/j.1440-0960.2011.00819.x
- Parsi K, 2011, AUSTRALAS J DERMATOL, V52, P159, DOI 10.1111/j.1440-0960.2011.00749.x
- Quaresma MV, 2015, AN BRAS DERMATOL, V90, P745, DOI 10.1590/abd1806-4841.20153394
- Timoney Irene, 2019, BMJ Case Rep, V12, DOI 10.1136/bcr-2019-232670
- TODA M, 2003, JPN J CLIN DERMATOL, V57, P712
- Uthman IW, 2006, J RHEUMATOL, V33, P2379
- Weinstein S, 2008, HEMATOL ONCOL CLIN N, V22, P67, DOI 10.1016/j.hoc.2007.10.011
- Wohlrab J, 2001, BRIT J DERMATOL, V145, P285, DOI 10.1046/j.1365-2133.2001.04348.x