Livedo reticularis is a merker for predicting multi-system thrombosis in antiphopholipid syndrome

Elias Toubi, Ilan Krause, Abigail Fraser, Shaul Lev, L. Stojanovich, J. Rovensky, Miri Blank, Yehuda Shoenfeld

Research output: Contribution to journalArticlepeer-review


Objective: Livedo reticularis (LR) is a skin vasculopathy that has been frequently described in patients with anti-phospholipid syndrome (APS) and reported to be present in association with valvular heart pathology and strokes (i.e. Sneddons syndrome). Methods: In a cohort of APS patients we investigated the possible association of LR with various clinical aspects of APS such as pregnancy morbidity, central nervous system (CNS) and cardiac manifestations. Results: Livedo reticularis was found in 50/308 (16%) of APS patients, and there was a significant association with cerebrovascular accidents (CVA), migraines and epilepsy (p = 0.01, 0.002, and 0.02 respectively). A similar association was also detected between LR, and the presence of cardiac valve thickening and vegetations (p = 0.001). No association with venous thrombosis, recurrent fetal loss, IUGR or toxemia was found. Conclusion: Livedo reticularis is a frequent cutaneous manifestation in patients with APS. Its high association with cardiac and CNS thrombosis may suggest that LR-APS patients compose a subset at higher risk for thrombosis, and thus may require a closer follow-up and a more aggressive anticoagulation.

Original languageEnglish
Pages (from-to)499-504
Number of pages6
JournalClinical and Experimental Rheumatology
Issue number4
StatePublished - 2005
Externally publishedYes


  • Anti-phospholipid syndrome
  • Livedo reticularis
  • Thrombosis


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