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Dermatopathology: Practical & Conceptual July - September 2005
4. Understanding livedo vasculitis: Part I—A glossary, in historical perspective, of terms related to "livedo" and "livedo vasculitis"
K. C. Nischal, M.D.
Almut Böer, M.D.
1860: livedo reticularis
1907: livedo racemosa
1929: atrophie blanche
capillarite télangiectasique et atrophiante
capillarites sclérosantes et atrophiantes
1953: capillaritis alba
1955: livedo reticularis with summer ulceration
1956: livedo reticularis with ulcerations
1957: atrophia alba
1965: Sneddon syndrome
1966: periodic painful ulcers of lower extremities
1967: livedo vasculitis
1967: segmental hyalinizing vasculitis
1974: livedoid vasculitis
1974: livedo reticulosis
1974: vasculitis of atrophie blanche
1983: PURPLE (painful purpuric ulcers with reticular patterning on the lower extremities)
1992: livedo vasculopathy
1998: livedoid vasculopathy
Suggestion for terminology
I. Useful terms
II. Confusing terms—to be avoided
III. Antiquated terms—not to be used any more
1860: livedo reticularis
It is not known who coined the term "livedo reticularis," but Hebra, in 1860, [
] described under the name "livedo calorica" a "bluish color of skin consequent to the influence of cold." He had observed that some patients, when undressing at a temperature of 14 degrees Celsius, developed a netlike bluish color that reminded him of the blue patches that develop on the skin of a corpse. Hebra noted that the netlike coloration subsided on pressure as well as on warming the skin. Darier, in 1936, [
] described the same findings clinical and designated them "livedo anularis a frigore" or "asphyxia reticularis" and he also noted that some authors had termed the very same condition "cutis marmorata" because of the marble-like appearance of the skin.
In English-speaking dermatology, especially subsequent to an article by Champion, in 1965, [
] livedo reticularis has come to be used interchangeably with livedo racemosa
livedo racemosa) whereas in German- and French-speaking dermatology, both terms are defined differently. Livedo reticularis, as the term implies, refers to a netlike pattern
is Latin for "net"), and livedo racemosa refers to a branched, ramified pattern of livedo
is Latin for "branches of a grape"). Whereas livedo reticularis is due to vasospasms that resolve with warming the skin, livedo racemosa, in the restricted sense, is consequent to vasculitis and/or thrombosis of small vessels and not responsive to warming the skin.
Colleagues who speak of "transient" livedo reticularis are actually referring to livedo reticularis in the restricted sense
. cutis marmorata), and those who mention "persistent" livedo reticularis are usually speaking about livedo racemosa as it was defined originally (see also livedo racemosa). Livedo reticularis has been said to be associated with neurologic signs and symptoms [
Sneddon syndrome), with lupus erythematosus, [
] with periarteritis nodosa, [
] and with livedo vasculitis. [
] In all these conditions, what colleagues really pictured in their articles was a branched, bluish to reddish discoloration (which correctly is called livedo racemosa) and not a netlike, transient, one (livedo reticularis).
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