Cutaneous manifestations of antiphospholipid antibody syndrome

Many different cutaneous lesions or cutaneous-systemic syndromes can be the presenting sign of antiphospholipid antibody syndrome (APS), or can develop during the course of disease. None of these conditions are specific for APS. Livedo reticularis or racemosa is commonly seen in APS, but it is one of the least specific findings. Other diseases are less commonly seen, in either their idiopathic or APS-associated form, but are more suggestive of APS. APS should be considered in patients who may appear to have idiopathic livedo reticularis with cerebrovascular accidents (Sneddon's syndrome), atrophie blanche, livedoid vasculitis, malignant atrophic papulosis, or anetoderma. Finally, retiform (branching, stellate) purpura or necrosis is perhaps the most characteristic cutaneous lesion of many different cutaneous microvascular occlusion syndromes, including APS.