{"id":24749,"date":"2026-02-28T22:54:25","date_gmt":"2026-03-01T02:54:25","guid":{"rendered":"https:\/\/cliniqueomicron.ca\/livedo\/"},"modified":"2026-03-16T01:31:42","modified_gmt":"2026-03-16T05:31:42","slug":"livedo","status":"publish","type":"page","link":"https:\/\/cliniqueomicron.ca\/en\/livedo\/","title":{"rendered":"Livedo (Livedo Reticularis): Causes, Diagnosis, and Treatment | Clinique Omicron"},"content":{"rendered":"
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\n\t\t\t\t\t\n\n\n\n\nLivedo (Livedo Reticularis): Causes, Diagnosis, and Treatment | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"Livedo reticularis is a mottled reddish-purple network of the skin caused by a cutaneous circulatory anomaly. Physiological, autoimmune, or embolic \u2014 diagnosis and management in Quebec.\">\n<meta name=\"keywords\" content=\"livedo reticularis traitement, livedo physiologique, livedo lupus anticorps antiphospholipides, livedo vasospasme, livedo embolies cholest\u00e9rol, livedo cutis marmorata, livedo racemosa, livedo Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n.co-wrap*{font-family:'Poppins',sans-serif;box-sizing:border-box}\n.co-wrap{max-width:1100px;margin:0 auto;padding:30px 0 60px}\n.co-label{font-family:'Cinzel',serif;font-size:14px;font-weight:bold;letter-spacing:1px;text-transform:uppercase;color:#4D6577;margin-bottom:14px;display:block}\n.co-wrap h1{font-size:32px;font-weight:500;color:#323C52;margin:0 0 22px;line-height:1.2}\n.co-intro{font-size:16px;line-height:1.75;color:#4D6577;margin-bottom:36px;padding-bottom:32px;border-bottom:1px solid rgba(77,101,119,.2)}\n.co-wrap h2{font-size:20px;font-weight:600;color:#323C52;margin:32px 0 12px}\n.co-wrap p{font-size:15px;color:#4D6577;line-height:1.7;margin-bottom:14px}\n.co-list{list-style:none;padding:0;margin:12px 0 24px}\n.co-list li{font-size:15px;color:#4D6577;padding:10px 14px 10px 38px;margin-bottom:8px;border-radius:6px;position:relative;background:rgba(77,101,119,.06);border-left:3px solid #4D6577}\n.co-list li::before{content:\"\u2713\";position:absolute;left:12px;font-weight:700;color:#4D6577}\n.co-table{width:100%;border-collapse:collapse;margin:14px 0 22px;font-size:14px;border-radius:8px;overflow:hidden;table-layout:fixed}\n.co-table thead tr{background:#323C52;color:#fff}\n.co-table thead th{padding:11px 16px;text-align:left;font-weight:600;font-size:13px}\n.co-table tbody tr:nth-child(even){background:rgba(77,101,119,.06)}\n.co-table tbody tr:nth-child(odd){background:#fff}\n.co-table td{padding:10px 16px;color:#4D6577;border-bottom:1px solid rgba(77,101,119,.12);font-size:14px;vertical-align:top}\n.co-table td:first-child{font-weight:600;color:#323C52}\n.co-infobox{display:flex;gap:12px;background:rgba(77,101,119,.06);border-radius:8px;border-left:4px solid #4D6577;padding:14px 18px;margin:18px 0 28px;font-size:14px;color:#4D6577;line-height:1.65}\n.co-infobox .ico{font-size:18px;flex-shrink:0}\n.co-urgence{background:#fff8f8;border-left:5px solid #c0392b;border-radius:6px;padding:20px 26px;margin:24px 0 32px}\n.co-urgence .co-urgence-titre{font-size:13px;font-weight:700;color:#c0392b;letter-spacing:1.5px;text-transform:uppercase;margin-bottom:10px}\n.co-urgence p{color:#5a2020;font-size:14px;margin:0 0 10px;line-height:1.7}\n.co-urgence p:last-child{margin-bottom:0}\n.co-disclaimer{font-size:13px;color:#8a9aaa;font-style:italic;border-top:1px solid rgba(77,101,119,.15);padding-top:24px;margin-top:40px;line-height:1.6}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n <span class=\"co-label\">Dermatology & Rheumatology & Internal Medicine & Family Medicine<\/span>\n <h1>Livedo (livedo reticularis)<\/h1>\n\n <div class=\"co-intro\">\n Le livedo reticularis (LR) est un aspect cutan\u00e9 en r\u00e9seau marbr\u00e9 rouge-violac\u00e9 ou bleut\u00e9, formant un dessin r\u00e9ticul\u00e9 (en mailles ou en filet) sur la peau, particuli\u00e8rement visible aux membres inf\u00e9rieurs et au tronc. Ce signe clinique t\u00e9moigne d'une anomalie de la microcirculation cutan\u00e9e \u2014 une perturbation du flux sanguin dans les vaisseaux dermiques (capillaires + art\u00e9rioles + veinules) entra\u00eenant une stase sanguine et une d\u00e9soxyg\u00e9nation localis\u00e9e de l'h\u00e9moglobine (h\u00e9moglobine d\u00e9satur\u00e9e = violac\u00e9e). La physiopathologie repose sur l'anatomie vasculaire cutan\u00e9e en \u00ab c\u00f4nes \u00bb (angiomes art\u00e9riolaires centrifuges) \u2014 chaque art\u00e9riole centrale irrigue une zone cutan\u00e9e circulaire, et la stase dans la p\u00e9riph\u00e9rie de ces zones produit le r\u00e9seau marbr\u00e9 caract\u00e9ristique. Le terme livedo recouvre en r\u00e9alit\u00e9 un spectre de pr\u00e9sentations cliniques allant du livedo physiologique b\u00e9nin (cutis marmorata) \u2014 entit\u00e9 r\u00e9versible \u00e0 la chaleur + sym\u00e9trique + sans cause syst\u00e9mique \u2014 au livedo racemosa pathologique \u2014 r\u00e9seau irr\u00e9gulier + persistant + non sym\u00e9trique + t\u00e9moin potentiel d'une pathologie syst\u00e9mique sous-jacente s\u00e9rieuse (syndrome des antiphospholipides + lupus + cryoglobulin\u00e9mie + embolies de cholest\u00e9rol + vasculite + polycyth\u00e9mie vera + thrombophilie). La distinction entre ces formes est cruciale : un livedo physiologique ne n\u00e9cessite aucun bilan, tandis qu'un livedo racemosa chez un adulte impose un bilan syst\u00e9mique orient\u00e9. L'association livedo + AVC + thromboses art\u00e9rielles + avortements r\u00e9currents chez une femme jeune est tr\u00e8s \u00e9vocatrice du syndrome des antiphospholipides (SAPL).\n <\/div>\n\n <h2>Pathophysiology, classification and etiologies<\/h2>\n <ul class=\"co-list\">\n <li><strong>Vascular Pathophysiology and Classification of Livedo:<\/strong> cutaneous vascular anatomy and livedo mechanism: cutaneous microcirculation is organized into conical vascular units (central ascending arterioles \u2192 dermal capillaries \u2192 peripheral return venules) \u2192 each arteriole irrigates a circular territory whose periphery is the least oxygenated \u2192 in the event of slowed flow (vasospasm + obstruction + increased blood viscosity) \u2192 stasis in the periphery of the cones \u2192 hemoglobin deoxygenation \u2192 reddish-purplish colorationpurplish \u2192 reticulated network appearance \u2192 net meshes correspond to junction zones between several adjacent vascular cones + livedo clinical classification: cutis marmorata (physiological livedo): regular + symmetrical net + disappears with heat + found in thin young subjects in cold environments + or in infants + reversible \u2192 no investigation necessary \u2192 livedo reticularis (LR proper): regular + symmetrical net + persistent despite warming + may be primary idiopathic (especially young women) + or secondary (systemic causes) \u2192 livedo racemosa (LRa): most worrying + irregular + broken + non-symmetrical + persistent + does not disappear with heat + often associated with serious systemic causes + may involve trunk + face + arms \u2192 terminology: some authors group LR + LRa under the term \u00ablivedo reticularis\u00bb and distinguish only physiological vs pathological \u2192 the regular LR vs irregular LRa distinction is clinically the most useful for orienting the workup + main pathophysiological mechanisms: vasospasm (sympathicotonic or primitive) \u2192 spastic arterioles \u2192 slowed flow \u2192 stasis + vascular obstruction: thrombus + emboli (cholesterol + cardiogenic + antiphospholipid) + cryoglobulin crystals + sickle cells \u2192 central arteriole blockage \u2192 central ischemia + livedo + increased blood viscosity : polycythemia + cryoglobulinemia + infections + autoimmune diseases \u2192 stasis by slowing down + inflammatory lesion of the vascular wall (vasculitis) \u2192 increased permeability + stasis<\/li>\n <li><strong>\u00c9tiologies principales et approche diagnostique selon le profil clinique :<\/strong> physiological livedo (cutis marmorata): infant (very frequent - immature thermoregulation) + thin young adult in cold environment + symmetrical + disappears with heat \u2192 NO investigation necessary + idiopathic primary livedo: young woman (20-40 years) + persistent regular LR + no systemic cause identified + associated acrocyanosis possible + livedo secondary to systemic causes - to be investigated according to clinical context : antiphospholipid syndrome (SAPL): classic and important association \u2192 livedo racemosa + arterial or venous thromboses + recurrent abortions + antiphospholipid antibodies (anticoagulant lupus + anticardiolipin + anti-\u03b22-GPI) \u2192 Levine 2002 - NEJM: SAPL criteria \u2192 reference \u2192 systemic lupus erythematosus (SLE): livedo + systemic manifestations of lupus \u2192 ANA + anti-DNA + complement \u2192 cryoglobulinemia: livedo + purpura + arthralgias + neuropathy + renal involvement \u2192 cryoglobulins \u2192 HCV screening \u2192 cholesterol crystal emboli: very characteristic livedo (often in lower limbs + blue toe) \u2192 after vascular procedure (catheterization + thrombolysis) + or spontaneous \u2192 eosinophilia + progressive CKD \u2192 skin biopsy (biconvex \u00abneedle\u00bb crystals in arterioles) \u2192 polycythemia vera + essential thrombocythemia: hypervisocity \u2192 CBC + JAK2 \u2192 vasculitides: PAN (periarteritis nodosa) + other vasculitides \u2192 biopsy + ANCA + Raynaud's + vasospasm \u2192 livedo secondary to drugs: amantadine (treatment of Parkinson's disease) \u2192 reversible benign livedo + interferon + quinine + catecholamines + particular clinical associations: Sneddon syndrome: livedo racemosa + recurrent ischemic stroke + associated SAPL in 50 % \u2192 skin biopsy (thrombotic obliteration of arterioles) <\/ul>\n\n <h2>Diagnostic \u00e9tiologique et traitement<\/h2>\n <table class=\"co-table\">\n <colgroup><col style=\"width:200px;\"><col style=\"width:42%;\"><col><\/colgroup>\n <thead>\n <tr><th>\u00c9tiologie \/ approche<\/th><th>Assessment, diagnosis and treatment<\/th><th>References and recommendations<\/th><\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Livedo and Antiphospholipid Syndrome (APS)<br><small style=\"font-weight:400;color:#7a8fa0;\">Anticorps antiphospholipides \u2014 lupus anticoagulant \u2014 anticardiolipine \u2014 anti-\u03b22-GPI \u2014 thrombose \u2014 AVC \u2014 avortements \u2014 anticoagulation \u2014 aspirine \u2014 hydroxychloroquine \u2014 crit\u00e8res Sapporo \u2014 syndrome Sneddon \u2014 livedo racemosa<\/small><\/td>\n <td>Livedo et syndrome des antiphospholipides (SAPL) \u2014 association capitale : le SAPL est la cause secondaire la plus importante et la plus grave du livedo racemosa chez la femme jeune \u2192 profil clinique \u00e9vocateur : femme jeune (20\u201340 ans) + livedo racemosa (r\u00e9seau irr\u00e9gulier + persistant + parfois bras + tronc) + ATCD de thromboses (TVP + EP + AVC + IDM) + avortements r\u00e9currents (\u22653 avortements spontan\u00e9s avant 10 SA + ou \u22651 mort f\u0153tale >10 SA + ou naissance pr\u00e9matur\u00e9e <34 SA par pr\u00e9\u00e9clampsie) \u2192 crit\u00e8res de classification du SAPL (Sapporo r\u00e9vis\u00e9s 2006 \u2014 Miyakis) : cliniques (1 crit\u00e8re) : thrombose vasculaire + ou morbidit\u00e9 obst\u00e9tricale \u2192 biologiques (1 crit\u00e8re) : lupus anticoagulant (LA) + ou anticardiolipine IgG ou IgM (titre moyen\/\u00e9lev\u00e9 \u2014 >40 GPL ou MPL) + ou anti-\u03b22-GPI IgG ou IgM \u2192 2 dosages \u00e0 12 semaines d'intervalle n\u00e9cessaires pour confirmer la persistance \u2192 bilan biologique du SAPL : lupus anticoagulant (LA) : dosage fonctionnel \u2014 temps de venin de vip\u00e8re de Russell dilu\u00e9 (DVVT) + ratio APTT + \u2192 anticardiolipine IgG + IgM (ELISA) + anti-\u03b22-GPI IgG + IgM (ELISA) \u2192 bilan immunologique associ\u00e9 : ANA + anti-ADN + compl\u00e9ment (C3 + C4) + bilan r\u00e9nal (prot\u00e9inurie) \u2192 NFS (thrombocytop\u00e9nie associ\u00e9e au SAPL) \u2192 traitement du SAPL : thrombose veineuse \u2192 anticoagulation par AVK (INR 2\u20133) au long cours \u2192 ou HBPM si grossesse \u2192 thrombose art\u00e9rielle \u2192 INR 3\u20134 + aspirine \u2192 ou aspirine + clopidogrel si INR 2\u20133 \u2192 pr\u00e9vention primaire (anticorps positifs sans thrombose) : aspirine 75\u2013100 mg\/j \u2192 hydroxychloroquine (Plaquenil) : r\u00e9duit le risque de thrombose dans le LES + SAPL primaire \u2192 SAPL obst\u00e9trical sans thrombose : aspirine + HBPM \u00d7 toute la grossesse + syndrome de Sneddon \u2192 SAPL dans 50 % des cas \u2192 bilan SAPL + AVC \u2192 anticoagulation si thrombotique<\/td>\n <td>Levine 2002 \u2014 NEJM : SAPL + thromboses + livedo \u2192 crit\u00e8res \u2192 r\u00e9f\u00e9rence + Miyakis 2006 \u2014 Journal of Thrombosis and Haemostasis : crit\u00e8res de classification r\u00e9vis\u00e9s SAPL (Sapporo) \u2192 r\u00e9f\u00e9rence + Cervera 2009 \u2014 European Journal of Clinical Investigation : SAPL + livedo + syndrome de Sneddon \u2192 Giannakopoulos 2009 \u2014 Arthritis and Rheumatism : SAPL + anticorps + bilan \u2192 SRC (Soci\u00e9t\u00e9 canadienne de rhumatologie) + EULAR 2019 guidelines SAPL : traitement + anticoagulation + grossesse + INESSS Qu\u00e9bec + RAMQ : AVK + HBPM + aspirine + hydroxychloroquine \u2192 rembours\u00e9s + anticoagulants directs (non recommand\u00e9s en SAPL) + bilan antiphospholipides rembours\u00e9 <\/tr>\n <tr>\n <td>Livedo et embolies de cholest\u00e9rol, cryoglobulin\u00e9mie et vasculites<br><small style=\"font-weight:400;color:#7a8fa0;\">Embolies cholest\u00e9rol orteil bleu \u2014 cath\u00e9t\u00e9risme \u2014 thrombolyse \u2014 \u00e9osinophilie \u2014 IRC \u2014 biopsie cutan\u00e9e cristaux \u2014 cryoglobulin\u00e9mie VHC \u2014 purpura arthralgies \u2014 PAN vasculite \u2014 biopsie \u2014 ANCA \u2014 polycyth\u00e9mie vera JAK2 \u2014 traitement \u00e9tiologique<\/small><\/td>\n <td>Livedo et embolies de cholest\u00e9rol (ath\u00e9roembolisme) : tableau clinique caract\u00e9ristique : livedo tr\u00e8s \u00e9vocateur (r\u00e9seau marbr\u00e9) + \u00ab orteil bleu \u00bb (isch\u00e9mie distale aigu\u00eb d'un ou plusieurs orteils = pathognomonique) + ou n\u00e9crose digitale + douleur des membres inf\u00e9rieurs + survient souvent apr\u00e8s une proc\u00e9dure vasculaire (cath\u00e9t\u00e9risme art\u00e9riel + chirurgie vasculaire + thrombolyse + anticoagulation intensive) + ou spontan\u00e9ment dans l'ath\u00e9roscl\u00e9rose s\u00e9v\u00e8re + contexte : patient \u00e2g\u00e9 + tabagique + ath\u00e9romateux + IRC progressive (glom\u00e9rulopathie thrombo-embolique) + \u00e9osinophilie p\u00e9riph\u00e9rique (lib\u00e9ration de m\u00e9diateurs pro-inflammatoires par les cristaux de cholest\u00e9rol) \u2192 \u00e9osinophilie + IRC + livedo + orteil bleu apr\u00e8s cath\u00e9t\u00e9risme = ath\u00e9roembolisme jusqu'\u00e0 preuve du contraire \u2192 bilan : fond d'\u0153il (cristaux de cholest\u00e9rol = plaques de Hollenhorst dans les art\u00e9rioles r\u00e9tiniennes) + cr\u00e9atinine + bilan r\u00e9nal + \u00e9osinophiles + biopsie cutan\u00e9e (ou musculaire + r\u00e9nale) \u2192 cristaux de cholest\u00e9rol biconvexes \u00ab en aiguilles \u00bb dans les art\u00e9rioles \u2192 traitement : PAS de traitement sp\u00e9cifique efficace + stopper l'anticoagulation si possible (aggrave l'embolisation) + statines (r\u00e9duisent les rechutes + effets anti-inflammatoires) + \u00e9viter nouvelles proc\u00e9dures vasculaires si possible + traitement conservateur + soins locaux \u2192 pronostic : variable \u2014 IR progressive dans 50 % des cas ; livedo et cryoglobulin\u00e9mie : livedo + purpura palpable + arthralgies + neuropathie + atteinte r\u00e9nale + VHC dans 80\u201390 % des cryoglobulin\u00e9mies de type II \u2192 cryoglobulines (\u00e0 doser sur pr\u00e9l\u00e8vement chaud +37\u00b0C) \u2192 FR + compl\u00e9ment C4 effondr\u00e9 + traitement de la cause (antiviraux VHC : sofosbuvir + ribavirine) + rituximab si cryoglobulin\u00e9mie symptomatique + livedo et vasculites syst\u00e9miques : PAN (p\u00e9riart\u00e9rite noueuse) \u2192 livedo + infarctus visc\u00e9raux (rein + m\u00e9sent\u00e8re) + neuropathie + ANCA n\u00e9gatif (PAN classique) \u2192 biopsie cutan\u00e9e ou neuromusculaire + cryoglobulin\u00e9mies associ\u00e9es (PAN + VHB dans 30\u201350 %) \u2192 traitement : cortico\u00efdes + cyclophosphamide + polycyth\u00e9mie vera \/ thrombocyt\u00e9mie essentielle : hyperviscosit\u00e9 + thromboses + livedo \u2192 NFS + JAK2 V617F \u2192 phl\u00e9botomies + hydroxyur\u00e9e + aspirine<\/td>\n <td>Kronzon 2010 \u2014 Journal of the American College of Cardiology : embolies de cholest\u00e9rol \u2192 livedo + orteil bleu + \u00e9osinophilie + biopsie \u2192 diagnostic + traitement \u2192 r\u00e9f\u00e9rence + Scolari 2007 \u2014 Kidney International : ath\u00e9roembolisme r\u00e9nal + IRC + livedo + pronostic + Ferri 2004 \u2014 Arthritis and Rheumatism : cryoglobulin\u00e9mie + VHC + livedo + Guillevin 1995 \u2014 Archives of Internal Medicine : PAN + livedo + vasculite + Verstovsek 2009 \u2014 NEJM : JAK2 + polycyth\u00e9mie vera \u2192 SRC + Soci\u00e9t\u00e9 canadienne de dermatologie (SCD) + INESSS Qu\u00e9bec : bilan livedo + \u00e9tiologique + RAMQ : cryoglobulines + ANA + ANCA + biopsie cutan\u00e9e + rembours\u00e9s + antiviraux VHC + rituximab \u2192 rembours\u00e9s selon crit\u00e8res <\/tr>\n <tr>\n <td>Approche clinique du livedo \u2014 bilan \u00e9tiologique et traitement symptomatique<br><small style=\"font-weight:400;color:#7a8fa0;\">Livedo physiologique pas d'investigation \u2014 livedo pathologique bilan \u2014 NFS \u2014 ANA \u2014 anticorps antiphospholipides \u2014 cryoglobulines \u2014 compl\u00e9ment \u2014 cr\u00e9atinine \u2014 biopsie cutan\u00e9e \u2014 amantadine \u2014 r\u00e9chauffement \u2014 vasopl\u00e9gie \u2014 traitement de la cause \u2014 pentoxifylline \u2014 aspirine<\/small><\/td>\n <td>Approche clinique du livedo \u2014 strat\u00e9gie diagnostique : \u00e9tape 1 \u2014 distinguer le livedo physiologique du livedo pathologique : livedo physiologique (cutis marmorata) : filet r\u00e9gulier + sym\u00e9trique + dispara\u00eet compl\u00e8tement \u00e0 la chaleur + adolescent ou adulte jeune mince + sans sympt\u00f4mes associ\u00e9s \u2192 PAS d'investigation \u2192 r\u00e9assurance + livedo pathologique (racemosa ou LR persistant) : filet irr\u00e9gulier + et\/ou persistant malgr\u00e9 le r\u00e9chauffement + et\/ou chez un adulte >40 ans + et\/ou associ\u00e9 \u00e0 des signes syst\u00e9miques (AVC + thromboses + avortements + purpura + arthralgie + neuropathie + IR) \u2192 bilan \u00e9tiologique obligatoire \u2192 \u00e9tape 2 \u2014 bilan \u00e9tiologique syst\u00e9matique du livedo pathologique : NFS + frottis (\u00e9osinophilie \u2192 embolies de cholest\u00e9rol) + cr\u00e9atinine + ionogramme + bilan urinaire (prot\u00e9inurie) \u2192 ANA + anti-ADN + compl\u00e9ment C3 + C4 \u2192 anticorps antiphospholipides (lupus anticoagulant + anticardiolipine IgG\/IgM + anti-\u03b22-GPI IgG\/IgM) \u00d7 2 pr\u00e9l\u00e8vements \u00e0 12 semaines d'intervalle \u2192 cryoglobulines (sur tube chaud) \u2192 VS + CRP + FR \u2192 ANCA (si vasculite suspect\u00e9e) \u2192 NFS avec formule (JAK2 si polyglobulie ou thrombocytose) \u2192 bilan de thrombophilie si thromboses (facteur V Leiden + prothrombine 20210A + prot\u00e9ine C + prot\u00e9ine S + antithrombine) \u2192 imagerie : \u00e9cho-Doppler art\u00e9riel si embolies de cholest\u00e9rol suspect\u00e9es \u2192 fond d'\u0153il (plaques de Hollenhorst) \u2192 biopsie cutan\u00e9e : si diagnostic incertain + ou vasculite + ou embolies de cholest\u00e9rol suspect\u00e9es \u2192 biopsie profonde (prend les art\u00e9rioles du derme profond) \u2192 \u00e9tape 3 \u2014 traitement selon l'\u00e9tiologie : livedo physiologique : r\u00e9assurance + r\u00e9chauffement + bas de compression si g\u00eane \u2192 livedo primaire idiopathique : bas de compression \u00e9lastique + \u00e9viction du froid + vasodilatateurs (nif\u00e9dipine 10\u201330 mg\/j) + ou pentoxifylline (am\u00e9liore la d\u00e9formabilit\u00e9 des globules rouges) \u2192 si SAPL \u2192 anticoagulation AVK INR 2\u20133 (thrombose veineuse) + ou INR 3\u20134 (thrombose art\u00e9rielle) \u2192 si LES \u2192 hydroxychloroquine + si embolies de cholest\u00e9rol \u2192 statines + soins locaux \u2192 si cryoglobulin\u00e9mie \u2192 traitement du VHC + rituximab \u2192 si vasculite \u2192 cortico\u00efdes + cyclophosphamide<\/td>\n <td>Gibbs 2005 \u2014 Journal of the American Academy of Dermatology : livedo \u2192 classification + diagnostic + traitement \u2192 revue + Sajjan 2015 \u2014 Journal of the American Academy of Dermatology : livedo racemosa \u2192 \u00e9tiologies + bilan syst\u00e9mique + Miyakis 2006 \u2014 JTH : crit\u00e8res SAPL r\u00e9vis\u00e9s + Levine 2002 \u2014 NEJM : SAPL + livedo + traitement + Scolari 2007 \u2014 Kidney International : ath\u00e9roembolisme + livedo + Ferri 2004 \u2014 Arthritis and Rheumatism : cryoglobulin\u00e9mie + traitement + SRC + SCD + CMQ : livedo + investigation + traitement \u2192 EULAR 2019 SAPL guidelines + INESSS Qu\u00e9bec + RAMQ : bilan biologique + biopsie cutan\u00e9e + anticorps antiphospholipides \u2192 rembours\u00e9s + AVK + aspirine + hydroxychloroquine rembours\u00e9s <\/tr>\n <\/tbody>\n <\/table>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2139\ufe0f<\/span>\n <span><strong>Un livedo physiologique (cutis marmorata) \u2014 filet r\u00e9gulier + sym\u00e9trique + disparaissant \u00e0 la chaleur chez un jeune adulte mince \u2014 ne n\u00e9cessite aucun bilan et est b\u00e9nin :<\/strong> On the other hand, livedo racemosa (irregular pattern + persistent + asymmetrical) in an adult, especially when associated with thrombosis, strokes, recurrent miscarriages, or other systemic signs, requires an evaluation including antiphospholipid antibodies (APS), ANA (lupus), cryoglobulins, ANCA, CBC, and renal function tests. The combination of livedo + blue toe + eosinophilia after a vascular procedure is highly suggestive of cholesterol atheroembolism.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Situations n\u00e9cessitant une \u00e9valuation urgente ou prioritaire<\/div>\n <p><strong>Livedo racemosa + douleur aigu\u00eb d'un orteil + orteil bleu + froid + non pulsatile + dans les suites d'un cath\u00e9t\u00e9risme art\u00e9riel ou d'une thrombolyse + \u00e9osinophilie + IRC progressive<\/strong> \u2192 Atheroembolic cholesterol \u2192 urgent vascular evaluation \u2192 funduscopy + creatinine + eosinophils + skin biopsy \u2192 stop anticoagulation if possible + statins + local care \u2192 variable renal prognosis.<\/p>\n <p><strong>Femme jeune avec livedo racemosa + ATCD de TVP ou AVC ou avortements r\u00e9currents + ou trombocytop\u00e9nie inexpliqu\u00e9e + ou allongement inexpliqu\u00e9 de l'APTT<\/strong> \u2192 Probable antiphospholipid syndrome \u2192 Urgent workup: lupus anticoagulant + anticardiolipin IgG\/IgM + anti-\u03b22-GPI IgG\/IgM + ANA + anti-DNA + CBC + renal function tests \u2192 If current pregnancy \u2192 LMWH + aspirin immediately \u2192 Warfarin anticoagulation if thrombosis documented \u2192 Urgent rheumatology consultation.<\/p>\n <p><strong>Livedo + purpura palpable + arthralgies + neuropathie distale + atteinte r\u00e9nale + hypocompl\u00e9ment\u00e9mie (C4 effondr\u00e9) + FR positif<\/strong> \u2192 Probable cryoglobulinemia \u2192 Cryoglobulins on heated tube + HCV \u2192 Urgent HCV serology + immunoelectrophoresis \u2192 HCV treatment + rituximab if severe symptoms + rheumatology consultation + nephrology if renal involvement.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins de Clinique Omicron distinguent le livedo physiologique b\u00e9nin du livedo pathologique, prescrivent le bilan \u00e9tiologique complet (anticorps antiphospholipides + ANA + cryoglobulines + NFS + bilan r\u00e9nal + ANCA selon le contexte), orientent vers le rhumatologue, le dermatologue ou l'interniste pour les causes syst\u00e9miques, et assurent le suivi th\u00e9rapeutique (anticoagulation AVK + hydroxychloroquine + statines selon l'\u00e9tiologie). Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin, d'un dermatologue ou d'un rhumatologue. Un livedo pathologique est souvent le signe visible d'une maladie syst\u00e9mique sous-jacente grave n\u00e9cessitant un bilan sp\u00e9cialis\u00e9 et un traitement \u00e9tiologique adapt\u00e9.<\/p>\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Livedo (livedo reticularis) : causes, diagnostic et traitement | Clinique Omicron Dermatologie & Rhumatologie & M\u00e9decine interne & M\u00e9decine de famille Livedo (livedo reticularis) Le livedo reticularis (LR) est un aspect cutan\u00e9 en r\u00e9seau marbr\u00e9 rouge-violac\u00e9 ou bleut\u00e9, formant un dessin r\u00e9ticul\u00e9 (en mailles ou en filet) sur la peau, particuli\u00e8rement visible aux membres inf\u00e9rieurs… <a href=\"https:\/\/cliniqueomicron.ca\/en\/livedo\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Livedo (Livedo Reticularis): Causes, Diagnosis, and Treatment | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Livedo (livedo reticularis) : | Brossard | Clinique Omicron","_metasync_otto_description":"","_metasync_otto_keywords":"","_metasync_otto_og_title":"Livedo (livedo reticularis) : | Brossard | Clinique Omicron","_metasync_otto_og_description":"","_metasync_otto_twitter_title":"Livedo (livedo reticularis) : | Brossard | Clinique Omicron","_metasync_otto_twitter_description":"","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Livedo (livedo reticularis) : causes, diagnostic et traitement | Clinique Omicron","_aioseo_description":"Le livedo reticularis est un r\u00e9seau marbr\u00e9 rouge-violac\u00e9 de la peau caus\u00e9 par une anomalie circulatoire cutan\u00e9e. 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