NOTE: A patient who meets the clinical criteria (vascular thromboses and/or pregnancy morbidity) for the antiphospholipid syndrome is excluded from the definition.
Features:
(1) laboratory features of the antiphospholipid syndrome, with the presence of:
(1a) lupus anticoagulant
(1b) anticardiolipin antibody
(1c) anti-beta-glycoprotein I antibody
(1d) mixture of 2 or more types
(2) presence of a persistent reticular or mottled pattern to the skin that is
(2a) violaceous, red or blue
(2b) not reversible with warming (as might be seen with a cold agglutinin)
(3) exclusion another explanation for the skin findings
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Type of Pattern
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Shape
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Width of Reticular Pattern
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|
fine livedo racemosa
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irregular, broken circles
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< 10 mm
|
|
large livedo racemosa
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irregular, broken circles
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>= 10 mm
|
|
fine regular livedo reticularis
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regular, unbroken circles
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< 10 mm
|
|
large regular livedo reticularis
|
regular, unbroken circles
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>= 10 mm
|
Histologic features seen in a skin biopsy:
(1) luminal occlusion (partial or complete) in arterioles, small arteries or medium-sized arteries at the interface between the dermis and subcutaneous tissue
(2) absence of perivasculitis
(3) negative direct immunofluorescence
