Atrial myxoma with livedoid macules as its sole cutaneous manifestation

We report the second case of atrial myxoma associated with livedoid macules representing an embolic phenomenon. This case of atrial myxoma was of the sporadic type with no associated syndrome (such as the LAMB or NAME syndrome or Carney complex). A skin biopsy specimen from fading livedoid macules on the extremities showed a myxoid embolus inside dermal vessels, a diagnostic clue to the presence of an atrial myxoma. The histologic features of such lesions should alert the clinician to the presence of an otherwise silent atrial myxoma. Early surgical intervention may prevent the onset of severe neurologic deficits in such patients.