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Migraine is associated with livedo reticularis: a prospective study.
[sneddon syndrome]
To
investigate
the
relationship
of
livedo
reticularis
,
an
ischemic
dermatopathy
,
and
migraine
,
an
ischemic
stroke
risk
factor
.
Livedo
reticularis
refers
to
the
reddish-
blue
reticular
mottling
of
the
skin
resulting
from
narrowing
of
small
and
medium
arteries
at
the
dermis-subcutis
border
.
A
subset
of
patients
with
livedo
reticularis
develop
stroke
in
the
absence
of
other
vascular
risk
factors
,
which
has
been
termed
Sneddon
syndrome
.
We
undertook
this
prospective
study
in
a
non-neurology
clinic
to
delineate
further
the
relationship
of
livedo
reticularis
and
migraine
.
Patients
in
a
general
dermatology
clinic
were
interviewed
for
vascular
risk
factors
and
history
of
migraine
in
accordance
with
the
International
Headache
Society
(
IHS
)
criteria
.
A
dermatologist
,
not
familiar
with
the
interview
,
recorded
the
primary
dermatological
diagnosis
and
the
presence
or
absence
of
livedo
reticularis
on
examination
.
Two
hundred
eighty-
one
consecutive
patients
(
184
women
and
97
men
;
average
age
,
52
years
)
were
interviewed
and
examined
.
Seventy
-
five
(
27
%
)
had
migraine
(
IHS
codes
1
.
1
,
1
.
2
)
and
an
additional
18
(
6
%
)
had
atypical
migraine
(
IHS
1
.
7
)
.
Livedo
reticularis
was
noted
in
46
patients
(
16
%
)
,
with
the
frequency
higher
in
women
than
men
(
42
[
23
%
]
of
184
versus
4
[
4
%
]
of
97
;
P
<
.
0001
)
.
The
frequency
of
livedo
reticularis
in
patients
with
migraine
was
higher
than
in
those
without
migraine
(
24
[
26
%
]
of
93
versus
22
[
12
%
]
of
188
;
P
=
.
002
)
,
and
higher
in
female
than
male
migraineurs
(
23
[
32
%
]
of
72
versus
1
[
5
%
]
of
21
;
P
=
.
012
)
.
In
logistic
regression
analysis
of
the
women
,
migraine
was
associated
with
livedo
reticularis
(
odds
ratio
[
OR
]
,
2
.
3
;
confidence
interval
[
CI
]
,
1
.
08
to
4
.
71
)
,
as
well
as
with
stroke
(
OR
,
4
.
0
;
CI
,
0
.
87
to
18
.
21
)
,
coronary
artery
disease
(
OR
,
3
.
5
;
CI
,
1
.
16
to
10
.
33
)
,
and
deep
venous
thrombosis
(
OR
,
3
.
2
;
CI
,
0
.
98
to
10
.
32
)
.
In
women
,
migraine
is
associated
with
stroke
,
coronary
artery
disease
,
deep
venous
thrombosis
,
as
well
as
livedo
reticularis
,
a
dermatopathy
which
has
been
pathologically
linked
to
cerebral
vasculopathy
.
Whether
migraineurs
with
livedo
reticularis
compose
a
subset
at
higher
risk
of
thrombosis
,
including
stroke
,
deserves
further
investigation
.
Diseases
Validation
Diseases presenting
"the presence or absence of livedo reticularis on examination"
symptom
sneddon syndrome
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