Mottled skin causes a bluish-red, lace-like pattern under the skin. Also known as livedo reticularis, this condition happens when deoxygenated blood pools beneath the skin’s surface. The condition has many causes, including cold exposure and chronic medical conditions.
Mottled skin is usually a temporary condition. It occurs when blood flow to tiny vessels under your skin is disrupted. This results in a fine, bluish-red, lace-like pattern (reticula). The condition is also known as livedo reticularis.
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A similar condition, livedo racemosa, also results in a lace-like pattern on your skin. Livedo racemosa occurs when there’s a permanent disruption to blood flow. It results in larger reticula with broken circular segments.
The three main types are:
Yes. Other types include:
This condition (also called cutis marmorata telangiectatica congenita) occurs at birth and typically forms on a hand or foot. Congenital livedo reticularis may be associated with anomalies in other areas of the body, including your:
A reticular pattern forms due to extended heat exposure. It may stem from a:
This type occurs when healthcare providers have ruled out an underlying condition and determined that there’s no known cause (idiopathic). Idiopathic livedo reticularis is persistent, meaning that it may be present for a long time.
This is a secondary type of livedo reticularis. It occurs in about 25% of patients with primary antiphospholipid syndrome (APS) and up to 70% of those with lupus-associated APS.
The primary cause is decreased blood flow to your skin. When this occurs, oxygen-poor blood from tiny blood vessels pools under your skin. Mottled skin can have many other causes, including:
Autoimmune and connective tissue disorders that can lead to mottled skin include:
Cancerous growths can cause mottled skin if they disrupt blood flow. They include:
Mottled skin before death occurs because circulation is slowing. In this situation, reticula are accompanied by other end-of-life symptoms, including difficulty breathing.
Infectious diseases that cause livedo reticularis include:
Mottled skin can be a side effect of certain medications, including:
Conditions affecting peripheral nervous system functioning (nerves outside your brain and spinal cord) can cause livedo reticularis. These include:
Many vascular disorders cause mottled skin. Some are due to narrowed blood vessels, others because of blockages. They include:
Healthcare providers diagnose livedo reticularis by looking at your skin. They may review your health history and any chronic illnesses you’ve had. You may also need a skin biopsy or lab studies, such as urinalysis or blood tests.
The best therapy for you depends on the type:
You can prevent certain types, like primary livedo reticularis, by not exposing your skin to cold environments. Secondary livedo reticularis may be more challenging to prevent. If you have a condition that puts you at risk for mottled skin, it’s essential to follow care instructions closely.
Contact your healthcare provider if you notice a dark lace-like pattern on your skin. Since livedo reticularis can be a sign of many medical issues, a timely assessment is essential. This information helps your provider determine the cause so that you can receive treatments, if necessary.
The condition causes patches of discoloration in a lace-like pattern, with pale skin at the center. The reticula may be reddish-blue or purple and may come and go. Symptoms often affect only certain areas of your body, like your lower limbs.
A note from Cleveland Clinic
Livedo reticularis is often a harmless skin reaction to cold environments. Your outlook depends on the type and cause. Primary livedo reticularis often goes away shortly after warming the affected area. Secondary livedo reticularis is likely to go away with treatment for the underlying medical issue.
Last reviewed by a Cleveland Clinic medical professional on 11/08/2022.
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