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Each of these patients is unwell and presented with a rash on their legs.
For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately 2 minutes to complete. There is a list of suggested further reading material at the end of the quiz.
What is the name of the skin condition?
Livedo reticularis
What underlying systemic disease(s) or condition is it caused by?
His livedo reticularis was secondary to systemic polyarteritis nodosa. This was confirmed by histological examination of a deep skin biopsy. There was no significant systemic involvement on extensive investigation. Symptoms and signs rapidly improved with oral prednisone, which was slowly tapered over six months.
Livedo may be due to vasospasm (cutis marmorata), intraluminal pathology such as cryoglobulinaemia, or a hypercoagulable state such as antiphospholipid syndrome. Livedo due to medium-sized vessel wall pathology is rare, but potentially more serious, as it signifies cutaneous or systemic polyarteritis nodosa, or vasculitis in association with systemic lupus erythematosus. Treatment depends on the underlying disease.