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Intern Med. 2022 Feb 1; 61(3): 441.
PMCID: PMC8866785
PMID: 34776480

Livedo Reticularis Associated with COVID-19

A 57-year-old man was admitted in order to be treated for coronavirus disease 2019 (COVID-19). He had no past medical history, taking no medications or supplements. He has no history of COVID-19 vaccination. His main symptom was fever for three consecutive days. On admission, he also complained of mottled skin on his extremities appeared in the morning of the day before admission (Picture 1, ,2).2). His vital signs were stable and laboratory data did not show any blood coagulation abnormalities. His symptoms gradually improved as he demonstrated mild COVID-19 and consequently he was discharged on day 5 after hospitalization while his skin lesions still had not completely disappeared.

Freeman et al. reported that livedo reticularis-like lesions were observed in 3.5% of all cutaneous manifestations with COVID-19 (1). Since livedo reticularis is caused by a disturbance of the blood flow, it reminds us of the hypercoagulable state among COVID-19 patients. However, most of the livedo reticularis-like lesions associated with COVID-19 tend to be mild and transient, which is not associated with any thromboembolic events (2). When we encounter livedo reticularis-like lesions associated with COVID-19, we should observe it carefully but not administer any excessive treatments.

The authors state that they have no Conflict of Interest (COI).

Acknowledgement

We thank the entire staff at the COVID-19 ward in Ebara Hospital for their assistance in the clinical management.

References

1. Freeman EE, McMahon DE, Lipoff JB, et al. . The spectrum of COVID-19-associated dermatologic manifestations: an international registry of 716 patients from 31 countries. J Am Acad Dermatol 83: 1118-1129. [Europe PMC free article] [Abstract] [Google Scholar]
2. Genovese G, Moltrasio C, Berti E, Marzano AV.. Skin manifestations associated with COVID-19: current knowledge and future perspectives. Dermatology 237: 1-12, 2021. [Europe PMC free article] [Abstract] [Google Scholar]

Articles from Internal Medicine are provided here courtesy of Japanese Society of Internal Medicine

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