Livedo reticularis is a web-like pattern of discoloration in the skin. It happens because of problems with small blood vessels and may occur alongside rheumatoid arthritis (RA).

When you think about rheumatoid arthritis (RA), you probably think about its most common symptoms. These common symptoms include joint swelling and stiffness, bumps or nodules under your skin, and tiredness.

But some people with RA have other symptoms too. Some people with RA also experience a skin rash.

In RA, the body’s immune system attacks joint tissue. The same immune system problems that cause joint inflammation, swelling, and pain can also affect your skin.

When this happens, people with RA may develop lesions or rashes on the skin. This may occur because of RA inflammation causing damage to blood vessels.

Livedo reticularis causes visible, purple, or darkened blood vessels under the skin. These typically appear in a net-like pattern. A general rash can accompany this. It appears most often on your legs.

Livedo reticularis occurs because of decreased blood flow or spasms in the capillaries near the skin’s surface. This results in deoxygenated blood appearing blue in the vessels, which is then visible on the skin.

A person may experience short-term livedo reticularis because of cold temperature exposure. Damage to the blood vessels and blood clots can also cause it to occur.

RA inflammation can cause inflammation and damage to the blood vessel lining. The medical term for this inflammation is rheumatoid vasculitis.

This damage may cause livedo reticularis as a secondary outcome.

Besides livedo reticularis, different types of rashes you may experience in RA include:

  • Rheumatoid vasculitis: This condition causes inflammation of small and occasionally medium-sized blood vessels. It typically affects the fingers and toes but can occur in the eyes and heart.
  • Palmar erythema: This rare skin condition causes discoloration in the palms of the hands. On dark skin tones, palmar erythema may cause patches that are darker than the surrounding skin, while on lighter tones, it may appear red or pink.
  • Interstitial granulomatous dermatitis: This causes discolored lesions, plaques, or papules. These lesions typically occur around a person’s trunk and are often symmetrical and circle shaped.

Learn more about RA rashes here.

When diagnosing RA, doctors or healthcare professionals may look for rashes while assessing other symptoms.

As the first line of diagnosis, a doctor will look at your joints, check your mobility, and determine the presence or extent of autoimmune inflammation.

To diagnose the condition, they may order several blood tests, including:

  • rheumatoid factor test
  • complete blood count
  • anti-cyclic citrullinated peptide antibody test
  • erythrocyte sedimentation rate test
  • C-reactive protein test

Doctors may also use imaging technologies to assess the extent of the inflammation and joint damage. These may include X-rays and MRI ultrasounds.

Learn more about diagnosing RA here.

Rashes from RA are rare and may often result from other underlying conditions. Anyone with a persistent or severe rash should find medical attention. Similarly, anyone experiencing RA symptoms, such as joint inflammation and pain, should contact a doctor.

When RA affects the skin, it can lead to serious complications. For example, rheumatoid vasculitis can cause a lack of blood flow to the extremities, which can result in poor wound healing and ulcers. Secondary infections in these wounds can cause severe complications.

People with RA may develop rashes because of other underlying conditions. Because of this, the treatment for rash symptoms will vary, depending on their cause.

For example, people with RA may experience rashes because of a reaction to disease-modifying anti-rheumatic drugs or secondary hives.

Treatment for rheumatic skin conditions must be personalized for each person based on their condition and disease state. Therefore, any rash associated with RA requires a doctor’s supervision and treatment guidance.

Livedo reticularis is a skin symptom that can occur alongside RA. It results from spasms or a lack of blood flow in blood vessels near the skin.

The condition presents a net-like pattern of blue or purple blood vessels below the skin. People may also experience more general skin discoloration in the affected area.