The histopathological characteristics of livedo reticularis

Livedo reticularis (LR) is a skin disorder characterized by a reddish-blue mottling of the skin in a "fishnet" reticular pattern. The aim of this study was to investigate the major histopathological characteristics of LR and determine whether the histopathology of LR is more common in whitish areas or in the erythematous areas.

A clinical survey was carried out that included 16 patients with LR. The histopathological features were investigated with immunostains for factor VIII-related antigen, as well as routine hematoxylin-eosin.

There were no significant differences in thrombi, arterial obliteration, or RBC aggregates between the central blanched area and the peripheral erythematous areas. The computer-assisted image analyses of factor VIII-related antigen-stained sections revealed no significant difference in the number of dermal blood vessels and telangiectasia between the areas studied. There were nine cases that showed one or more of the histopathological features of LR in either the central blanched areas or the peripheral erythematous areas.

Our findings suggest that multiple punch biopsies should be performed in patients suspected of LR including both the peripheral erythematous and central whitish areas to increase the diagnostic yield.