title: Livedo reticularis is a marker for predicting multi-system thrombosis in antiphospholipid syndrome.
abstract: 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. Sneddon's 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Haifa Israel.
authors.forename: E
authors.initials: E
authors.lastname: Toubi
authors.forename: I
authors.initials: I
authors.lastname: Krause
authors.forename: A
authors.initials: A
authors.lastname: Fraser
authors.forename: S
authors.initials: S
authors.lastname: Lev
authors.forename: L
authors.initials: L
authors.lastname: Stojanovich
authors.forename: J
authors.initials: J
authors.lastname: Rovensky
authors.forename: M
authors.initials: M
authors.lastname: Blank
authors.forename: Y
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000328:Adult; D000368:Aged; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D015415:Biomarkers; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D006801:Humans; D007391:International Cooperation; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D017445:Skin Diseases, Vascular / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D018154:Slovakia / Q000453:epidemiology; D020246:Venous Thrombosis / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D015022:Yugoslavia / Q000453:epidemiology
chemical_list: D015415:Biomarkers