Mottled skin (Livedo Reticularis) Looks Like, Symptoms, Causes, Treatment

In general mottled skin is a temporary condition.  It appears as a lace-like, bluish-red pattern under the skin. This condition occurs when deoxygenated blood is clustered under the skin’s surface due to reduced blood flow.

What is mottled skin?

Mottled skin is a condition where it appears patchy or blotchy it’s also known as livedo reticularis. Mottled skin can have many causes, including connective tissue and autoimmune disorders, such as rheumatoid arthritis, dermatomyositis, and, lupus, rheumatoid arthritis. This occurs when there is reduced blood flow to the skin, causing oxygen-poor blood from tiny blood vessels to pool under the skin. Further potential causes include sepsis, cold exposure, certain medicines, and sepsis.

The treatment depends upon the primary causes. If mottled skin is caused by an infection, treating the infection can solve the issue. If it is caused by cold exposure, providing heat or warming the affected area can assist ease symptoms. In some cases, medication might be required to treat primary connective tissue or autoimmune disorders.

Note that mottled skin can be a sign of upset and needs instant medical consideration if it comes with other symptoms such as pale skin or breathing problems.

If you are experiencing the symptoms of mottled skin, immediately get an appointment with your health expert to determine the primary cause and suitable treatment options.   

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Major types of mottled skin:

Many types of livedo reticularis or mottled skin have been identified, including:

1. Physiologic:

This type of mottled skin is a risk-free and temporary condition. It’s also known as cutis marmorata due to cold exposure and it can go away when your skin warms up. It may affect young women and people assigned female at birth (AFAB) with lighter skin but commonly occurs in babies and children. 

2. Primary livedo reticularis:

This type of livedo reticularis is temporary and not associated with temperature changes. Primary mottled skin occurs when your blood vessels just under the skin’s surface suddenly contract for unidentified reasons. It is diagnosed when underlying conditions have been expelled.

3. Secondary livedo reticularis:

Livedo racemose is considered a secondary type of livedo reticularis and generally, it is associated with more severe underlying medical conditions, such as thrombotic or vasculitis disorders, certain cancers, and neurological disorders. Livedo racemosa is a persistent condition means it does not go away until the underlying condition is diagnosed and treated.    

Other types of Llivedo reticularis?

Are there other types of livedo reticularis?

Yes, there are some other types of livedo reticularis. Additionally, the types described above, further types of livedo reticularis include:

1. Idiopathic livedo reticularis:

This type of livedo reticularis relentless means, it may be present for a long period of time. Idiopathic livedo reticularis occurs when your health expert has excluded an underlying condition and determined that there is an unknown reason.

2. Erythema ab ign:

It may cause due to extensive heat exposure. It may branch from a:

• A heating pad is pressed against your skin for a long period.
• Long hot shower
• A laptop that overheats in your lap
• Fireplace or other contained heat source

3. Congenital livedo reticularis

This condition occurs at birth and usually appears on a foot or hand. Congenital livedo reticularis also called cutis marmorata telangiectasia congenita. This condition can be associated with abnormalities in other areas of the body such as:

• Eyes
• Skull and face
• Brain, spinal cord, and nerves
• Heart and vascular system

4. Livedo racemosa:

Livedo racemosa occurs in nearly 25% of patients with APS (antiphospholipid syndrome) and equates to 70% of those with lupus-associated APS. This is a secondary type of livedo reticularis.

Livedo reticularis associated with cryoglobulinemia: 

This type is linked with cryoglobulinemia, which is a condition in which abnormal proteins in the blood clump jointly and form deposits in the blood vessels.

Livedo reticularis associated with 

system lupus erythematosus (SLE):

Erythematosus is a disease that may affect the skin, organs, and joints.

Livedo reticularis associated with 

snedden syndrome:

It is linked with Sneddon syndrome, which is a rare condition that causes blood clots in small blood vessels. 

Livedo reticularis associated with dermatomyositis:

It is linked with dermatomyositis, which is a rare autoimmune disease that causes skin rashes and muscle weakness.

 Noted that, livedo reticularis may be associated with serious medical conditions if you are experiencing these symptoms should immediately seek medical attention to determine the primary cause.

Livedo reticularis associated with 

antiphospholipid syndrome:

Health experts linked livedo reticularis with antiphospholipid syndrome, which is an autoimmune disorder it may cause blood clots.

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What are the possible causes of mottled skin or livedo reticularis? 

The major reason for livedo reticularis is declined blood flow to the skin. When this condition occurs oxygen-poor blood from tiny blood vessels grouped under your skin. However, mottled skin may have several causes, such as: 

1. Infectious disease:

Infectious diseases that may cause mottled skin include:

• Brucellosis
• Atypical (walking) pneumonia
• Hepatitis C
• Syphilis
• Rheumatic fever
• Meningococcal disease
• Tuberculosis

2. Cancer:

If cancerous growths disrupt the blood flow it can cause mottled skin such as:

• Chronic lymphocytic leukemia
• Acute lymphocytic leukemia
• Kidney cancer
• Multiple myeloma
• Inflammatory breast cancer
• Mycosis fungoides 

3. Autoimmune and connective tissue 

disorders:

Mottled skin can be caused by autoimmune and connective tissue including

• Lupus
• Fibromyalgia
• Dermatomyositis
• Rheumatoid arthritis 

4. End of life:

Due to slow blood circulation, before death, mottled skin occurs. In this condition, reticula come with other end-of-life symptoms, such as difficulty breathing. 

5. Vascular disorders:

Mottled skin occurs due to several disorders. Some are due to contracted blood vessels, others because of blockages, including:

• Antithrombin deficiency
• Antiphospholipid syndrome
• Polyarteritis nodosa
• Polycythemia vera
• Deep vein thrombosis (DVT)
• Protein deficiency
• Cryoglobulinemia
• Temporal arthritis
• Protein S deficiency
•  Thrombocytosis

6. Neurological conditions:

Conditions that affect peripheral nervous system function (nerves get outside the spinal cord and brain) may lead to livedo reticularis including:

• Susac syndrome
• Multiple sclerosis (MS)
• Parkinson disease
• Complex regional pain syndrome

Diagnosis:

How mottled skin is diagnosed?

Your health experts diagnose mottled skin by looking at your skin. They may evaluate your health history and any chronic diseases you suffered. You may also require lab studies or a skin biopsy, such as blood tests or urinalysis.   

What types of livedo treatment might I 

need?

The treatment depends on the type of mottled skin

1. Primary livedo reticularis:

Regularly warm the affected area by taking a bath.

2. Secondary livedo reticularis:

Symptoms should recover by treating the underlying condition such as a vascular condition that may need anticoagulants.

3. Congenital livedo reticularis:

Congenital livedo reticularis goes away on its own but it will take some time.

4. Idiopathic livedo reticularis:

Increasing the influenced limb or wearing firm garments can improve blood flow.

5. Erythema ab igne:

Moving away from the cause is generally all that’s important. For lasting symptoms, you may require medicated cream, such as fluorouracil.

Prevention:

What can I do to prevent mottled skin?

You can stop certain types of mottled skin, such as livedo reticularis, by not divulging your skin to cold environments. But secondary livedo reticularis may be more difficult to prevent. If you have a condition that puts you at risk for mottled skin, it’s necessary to follow care instructions closely. 

When to call the doctor?

If you notice dark lace-like-patterns on your skin, immediately get an appointment with your health expert. While livedo reticularis may be a sign of several issues, a timely assessment is important. This information helps your doctor determine the reason so that you can get treatment, if important.

What does mottled skin look like?

Mottled skin causes patches of discoloration in lace-like patterns, with pale skin at the center. The reticula can be purple and reddish-blue and may go away. Symptoms frequently affect only certain areas of your body, like your lower limbs.