Mottled veins in feet and hands. Worse in mornings. Circulation issue?

Discussion in 'Cardiovascular and exercise physiology (CPET)' started by InitialConditions, May 14, 2019.

  1. InitialConditions

    InitialConditions Senior Member (Voting Rights)

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    I'm so sorry that you have to see my feet this early in the morning ;), but I'm interested to see if anyone here has the same issue.

    My feet, and to some degree my hands hands, look very different in the morning. Something is happening with the blood flow. I get a sort of mottled appearance (see photos). The first photo perhaps capures it best. The phone camera really doesn't do it justice.

    Now I am not so much worried about the prominent larger veins at the side of my feet - they have always been that way. It's the mottled pattern which I assume is related to circulation. Is this anything to do with livedo reticularis?

    Thanks for your input.

    20190514_093640.jpg 20190514_092542.jpg 20190514_092547.jpg 20190514_092727.jpg
     
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  2. chrisb

    chrisb Senior Member (Voting Rights)

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    I have suspected livedo reticularis for some time as an occasional symptom. I have never been able to ascertain what it might mean.
     
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  3. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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    I have the same thing, it tends to track with general health and has become more noticeable recently with it often visible on my upper arms, as well as hands and feet. Initially it was only noticeable when standing for long periods or with temperature changes, but now it is pretty consistently present.

    I always assumed it was livdeo reticularis and in my case maybe its related to hypermobility, autoimmunity, small fibre autonomic neuropathy and factor V leiden deficiency. All have been acknowledged as featuring it.
     
    Last edited: May 15, 2019
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  4. Dr Carrot

    Dr Carrot Senior Member (Voting Rights)

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    I have had this for quite some time, initially worried about it but sadly, as with most of our symptoms, stopped because I had more pressing issues elsewhere in the body :banghead:. Is it not maybe just something to do with circulation / blood pooling, feet warm and immobile overnight etc? Not dismissing as it's the first I've heard of livedo reticularis and it seems like several people share that experience.
     
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  5. Andy

    Andy Committee Member

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    I've seen it suggested as some kind of issue with the endothelial cells, which results in the blood vessels not constricting sufficiently to stop blood pooling, which obviously is most likely to be seen in the feet. Whatever the reason this happens to me pretty regularly in the mornings.
     
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  6. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Livedo reticularis has two meanings. In both cases it describes a red/blue/purple pattern that corresponds to the drainage territories of skin venules.

    In one sense it is a normal phenomenon that tends to occur with temperature changes. It is most often seen in the legs. Some people have it much of the time but particularly when the legs are cold. In this sense if you press on the coloured are it goes white (blanches) for a second or two and the colour returns.

    In the second sense LR is a pathological rash associated with lupus and other conditions that include vasculitis. It indicates a venulitis, hence the same pattern. In this case the colour is fixed and does not go away with pressure because the colour is due to blood cells leaking into the tissues. This sort of LR quite often occurs on the hands or in patches of limbs rather locally and lasts for a week or two. Normally it is an indication for specific treatments like steroids because it may be part of a more general vasculitis.

    The first sort of LR is probably about a ten thousand times more common than the second. The pictures at the top tend in the LR direction but would not be clear cut enough to classify as LR (of the normal first sort).
     
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  7. InitialConditions

    InitialConditions Senior Member (Voting Rights)

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    thanks for your replies folks.
     
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