Reticulated livedoid skin patterns after soft-tissue filler-related vascular adverse events

Area of Science:

• Dermatology
• Vascular Surgery
• Medical Imaging

Background:

• Vascular adverse events from filler injections can manifest as reticulated livedoid skin patterns.
• Duplex ultrasound imaging is a diagnostic tool for these events.
• Understanding the relationship between skin patterns and facial vasculature is crucial.

Purpose of the Study:

• To correlate reticulated livedoid skin patterns with duplex ultrasound findings.
• To link these patterns to specific facial perforasomes and arterial anatomy.

Main Methods:

• Investigated clinical features and duplex ultrasound findings in 125 patients.
• Examined six cadaver hemifaces to map vasculature and perforators.
• Compared clinical skin patterns with anatomical vasculature.

Main Results:

• Observed a correlation between facial skin patterns and underlying arterial anatomy/perforators.
• Duplex ultrasound revealed disturbed microvascularization in affected areas.
• Treatment with hyaluronidase led to clinical improvement and restored blood flow in perforator arteries.

Conclusions:

• Livedo skin patterns in vascular adverse events likely signify perforator involvement.
• Duplex ultrasound aids in diagnosing and managing these complications.
• Facial perforasomes are key to understanding these vascular events.