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Reticulate purpura, cryoglobulinaemia and livedo reticularis

E L Speight1, C M Lawrence

  • 1Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, U.K.

The British Journal of Dermatology
|September 1, 1993
PubMed

Insights

Reticulate purpura in cryoglobulinaemia may result from cryoprecipitate deposition in cooler skin areas. Reduced blood flow in physiological livedo reticularis areas may contribute to this pattern in patients with cryoglobulinaemia.

Area of Science:

  • Dermatology
  • Vascular Biology
  • Immunology

Background:

  • Cryoglobulinaemia is a condition characterized by the presence of cryoglobulins in the blood.
  • Patients often present with cutaneous manifestations, including purpura.
  • The characteristic reticulate pattern of purpura in some cases is not fully understood.

Observation:

  • Two patients with type I cryoglobulinaemia exhibited purpura in a reticulate pattern on their legs, mimicking physiological livedo.
  • This pattern suggests a potential link between localized cooling, blood flow, and cryoprecipitate deposition.

Findings:

  • Laser-Doppler velocimetry revealed significantly lower blood flux (21-26%) in the blue areas of physiological livedo reticularis compared to adjacent white areas in two out of three subjects.
  • This finding supports the hypothesis that sluggish blood flow and localized cooling in specific skin areas may promote cryoprecipitate formation.

Implications:

  • Understanding the pathogenesis of reticulate purpura in cryoglobulinaemia can aid in diagnosis and management.
  • This research highlights the role of microvascular physiology in the presentation of certain autoimmune or immune complex-mediated diseases.
  • Further investigation into localized cooling effects on cryoprecipitate deposition is warranted.

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