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Livedo reticularis is a common skin finding consisting of a mottled reticulated vascular pattern that appears as a lace-like purplish discoloration of the skin. [1] The discoloration is caused by reduction in blood flow through the arterioles that supply the cutaneous capillaries, resulting in deoxygenated blood showing as blue discoloration ().
Psoriatic arthritis tends to appear about 10 years after the first signs of psoriasis. [3] For the majority of people, this is between the ages of 30 and 55, but the disease can also affect children. The onset of psoriatic arthritis symptoms before symptoms of skin psoriasis is more common in children than adults. [48]
Other rheumatological disorders that can cause the features typical for RS3PE include late onset (seronegative) rheumatoid arthritis, acute sarcoidosis, ankylosing spondylitis and other spondyloarthropathies such as psoriatic arthropathy, mixed connective tissue disease, chondrocalcinosis and arthropathy due to amyloidosis.
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Psoriatic arthritis is a form of chronic inflammatory arthritis that has a highly variable clinical presentation and frequently occurs in association with skin and nail psoriasis. [ 31 ] [ 32 ] It typically involves painful inflammation of the joints and surrounding connective tissue and can occur in any joint, but most commonly affects the ...
There are also a number of other conditions that affect hands, feet, and parts of the face with associated skin color changes that need to be differentiated from acrocyanosis: Raynaud phenomenon, pernio, acrorygosis, erythromelalgia, and blue finger syndrome. The diagnosis may be challenging in some cases, especially when these syndromes co-exist.
Psoriatic erythroderma can be congenital or secondary to an environmental trigger. [12] [13] [14] Environmental triggers that have been documented include sunburn, skin trauma, psychological stress, systemic illness, alcoholism, drug exposure, chemical exposure (e.g., topical tar, computed tomography contrast material), and the sudden cessation of medication.
Furthermore, mongolian spots, large birthmarks, and the consumption of food products with blue or purple dyes can also result in the bluish skin tissue discoloration and may be mistaken for cyanosis. [ 2 ] [ 3 ] Appropriate physical examination and history taking is a crucial part to diagnose cyanosis.
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