Atrial myxoma syndrome mimicking Ehrmann-Sneddon syndrome.

[sneddon syndrome]

Livedo racemosa with cerebrovascular lesions has been described as Ehrmann-Sneddon syndrome . The etiopathogenetic factors provoking the vascular lesions , however , are of high diversity reaching from mechanical to autoimmune causes . We present a male patient with typical livedo racemosa , muscle pain and feeling of coldness of the forearms . By dermatohistopathology and magnetic resonance tomography of the brain , Ehrmann-Sneddon syndrome could be confirmed . At this time a chronic streptococcal infection could be diagnosed . Antibiotics , anticoagulants and vascularity-supplying therapy improved the clinical and subjective symptoms . Six months later , the patient developed dizziness , vision disorder , hypesthesia of the right forehead , malaise and weight loss . A further diagnostic workup including echocardiography revealed a myxoma of the left atrium . This report illustrates the association of Ehrmann-Sneddon syndrome with cardiac myxoma and points out that cardiac diagnostic examination should be included when dealing with small -vessel involvement of the brain .