Overview: livedo reticularis (livedo reticularis) is a local because the skin vasomotor dysfunction, resulting in a small artery spasm and small vein dilation, blood stasis and the limitations of the skin appear blue, purple livedo reticularis. According to their clinical characteristics, divided into primary and secondary, the former as a physiological phenomenon, common in normal children and adult women; the latter for a number of diseases of the skin manifestations.[Cause]
livedo reticularis is what causes it?
1. livedo reticularis primary cause of disease is unclear.
2. Livedo reticularis secondary disease may be secondary to many diseases, its pathogenesis is unclear. The most common autoimmune rheumatic disease (nodular periarteritis, rheumatoid arthritis, systemic lupus erythematosus, temporal arteritis), atherosclerosis, increased blood viscosity disease (polycythemia vera, thrombocythemia, cold agglutinin anemia, cryoglobulinemia, macroglobulinemia, etc.), venous disorders (superficial phlebitis, skin vasculitis), as well as burns, radiation, heat injury, congenital capillary expansion of the psychosis.
(B) the pathogenesis
1. a variety of small vessel wall damage
(1) or antiphospholipid antibody syndrome within the Division of Registration (Sneddon) syndrome, due to skin small artery endothelial proliferation leading to luminal stenosis, there livedo reticularis.
(2) non-specific inflammation of small blood vessels in the skin, mostly secondary to systemic lupus erythematosus, nodular nodosa and Sjogren's syndrome and other connective tissue disease.
(3) small vessel wall granulomatous skin violation, leading to stenosis, can be caused by certain pathogens, can also be Yinweigena (Wegener) granuloma caused.
(4) by the streptococcus, tuberculosis, hepatitis virus-induced allergic changes in small blood vessels, or by the tiny virus (parvovirus B19) directly caused by small changes in vessel wall have been reported.
2. in the vascular wall damage, based on the formation of thrombus or embolism due to multiple micro-vascular occlusion leading to small, can have the following situations.
(1) small vessel thrombosis is most common in connective tissue disease or abnormal immunoglobulin antibody-positive patients, antiphospholipid antibody syndrome were more common, including myocardial phospholipid antibodies, lupus anti-antibody and anti-β2-glycoprotein 1 antibodies, antibody-positive in more than a few more than half of the skin livedo reticularis performance.
(2) multiple small blood vessels through the femoral artery embolization and more as a variety of catheter angiography or interventional procedures, leading to the aorta, subclavian artery and other atherosclerotic plaque rupture caused by shedding of cholesterol crystals, followed by a number of primary renal failure patients prone to nocturnal high oxalic acid, oxalic acid crystals can lead to microvascular plugging bolt livedo reticularis.
(3) of the skin due to drug allergy cause livedo reticularis, skin biopsy has been confirmed by thrombosis, a known drug for acne minocycline (minocycline ), ergotamine treatment of migraine, a variety of β-blockers and some anti-tumor chemotherapy drugs, etc., there are other individual reported combined diethyl pyridine-dione diphenhydramine, amantadine and some hypnotics and so on.
3. caused by abnormal blood components livedo reticularis
(1) the most common coagulation factor abnormalities, such as Sneddon comprehensive levy for the factor V abnormalities, often with cerebral venous thrombosis.
(2) blood protein C deficiency, complement 1 inhibitor deficiency leads to vice hypoproteinemia, macroglobulinemia, cryoglobulinemia, anti-familial thromboxane Ⅲ deficiency, idiopathic thrombocythemia and diabetes, also can occur.
4. after birth the skin that may have livedo reticularis, congenital livedo reticularis as by long-term (8 to 21 years) observation can be found in other systems diseases such as cerebral infarction, hypertension, glaucoma, kidney damage, but the reason is unknown.
5. for regulating autonomic function caused by bad skin microvascular spasm and appear highly livedo reticularis, except those due to other causes of primary livedo reticularis.[Sign]
livedo reticularis early symptoms?
1. The disease is usually younger patients, mostly aged 20 to 40 can also be seen in infancy or old age, no gender differences. Generally no conscious discomfort, or only mild discomfort.
2. primary livedo reticularis, the patient showed gradual emergence of flaky skin, striped mesh or patchy stripes, veins clear, and some slightly higher than the leather, can occur in any part of the trunk and limbs, but the most common lower extremity. Local skin bruising, may have cold or numbness, paresthesia, but the extent is not heavy, usually no pain, and sometimes increased sweating. In a cold environment, when standing or drooping skin bruising physical network spot obvious, warm environment or Taigaohuanzhi is slightly better, but not completely disappeared, and the corresponding parts of the main arteries, such as the upper brachial artery, radial artery, lower extremity femoral artery,[Aftertreat]
livedo reticularis ate?[Prevent]
livedo reticularis should be how to prevent?
1. lift the ideological concerns of patients, attention to warm cold. Associated with calf and ankle for the next ulcers and symptoms, should stay in bed or restrict activities to promote healing.
2. should be the local thermal protection against cold.
3. Livedo reticularis for secondary disease in addition to giving treatment, prevention and treatment of the primary disease should be positive.[Treat]
livedo reticularis precautions before treatment?
1. primary livedo reticularis in patients given only symptomatic treatment, such as general Note the skin warm and avoid exposure to cold environment will cut out, cut out to prevent the formation of skin ulcers. Can be applied to vasodilator drugs, such as anisodamine, niacin (tobacco acid), niacin inositol (niacin inositol lipid), dextran 40 (dextran) and Mailuoning, also can be applied to Chinese herbs, such as blood circulation Salvia, safflower, Chuanxiong and so on.
2. secondary to various systemic diseases, systemic or secondary livedo reticularis patients, the cause of drug allergy should be given according to specific treatment, while to give the drug to improve skin microcirculation, and local warmth and so on.
(b) the prognosis
primary livedo reticularis of the natural prognosis of patients, duration of general last for months or years and relieve itself. Secondary to systemic disease or livedo reticularis systemic prognosis of patients with primary disease are closely related.
livedo reticularis Chinese medicine treatment methods
livedo reticularis Western medicine treatment
livedo reticularis should do what check?
1. based on the possible cause, select the relevant blood, urine and biochemical tests, the diagnosis of the cause is often important.
2. cerebrospinal fluid routine examination than non-specific.
3. immunizations check auxiliary and differential diagnosis.
head, body imaging with differential diagnosis.[Diff]
livedo reticularis and the diseases easily confused?
1. secondary livedo reticularis patients have clinical manifestations of primary disease, livedo reticularis is not easy to disappear.
2. Raynaud's disease disease is more common in women. Many originating in the hand, originating in the foot are rare. Onset of cold hands and feet, with pale skin, bruising and flushing phase changes, often accompanied by numbness, pins and needles. Onset of the gap period (toe) may have pain and tingling burning sensation. As the long-term repeated attacks, nutritional disorders, (toe) side appeared superficial necrosis or ulceration, pain more intense. In particular, changes in skin color and different with livedo reticularis.
3. hand, foot and hand, foot and skin cyanosis cyanosis continuous symmetric color, touch the wet, winter increase, occurred in young women, the normal limb pulse characteristics such as disease-oriented.[Disease]
livedo reticularis may be taken up by diseases?
livedo reticularis related diseases
livedo reticularis and blue spot vasculitis livedo reticularis
more skin symptoms
depression depressed scars scar scar damage after itching scar contraction depressed scars scars old age acne scarring rash maculopapular rash of the skin lesions after exposure back Zhangdou nasolabial red chapped skin lichen planus calcification of epidermal keratinocytes full thickness skin necrosis and exfoliation of the table dermatitis, pellagra-like rash
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