The following is a summary of “Reticulated livedoid skin patterns after soft-tissue filler–related vascular adverse events,” published in the July 2024 issue of Dermatology by Schelke, et al.
Duplex ultrasound imaging has emerged as a valuable tool for diagnosing and treating vascular adverse events associated with filler injections. Clinical observations of reticulated livedoid skin patterns prompted an investigation into their correlation with duplex ultrasound findings and the facial perforasomes. For a study, researchers sought to establish a connection between reticulated livedoid skin patterns, duplex ultrasound findings, and facial perforasomes.
Duplex ultrasound imaging was utilized to assess vascular adverse events in 125 patients. Clinical features and duplex ultrasound results were analyzed. Additionally, six cadaver hemifaces were examined to compare livedo skin patterns with facial vasculature.
Clinically, reticulated patterns on affected skin areas correlated with specific arterial anatomy and perforators in cadaver hemifaces. Duplex ultrasound revealed disrupted microvascularization in the superficial fatty layer. Following hyaluronidase injection, clinical improvement in skin pattern was observed, alongside normalization of blood flow and restoration of flow in corresponding perforator arteries. The observed skin patterns aligned with the distribution of perforators within superficial fat compartments.
The presence of livedo skin patterns in vascular adverse events is linked to the involvement of facial perforators. Duplex ultrasound findings and anatomical correlations underscored the utility of this approach in understanding and managing these dermatological complications.
Reference: sciencedirect.com/science/article/pii/S0190962224003402
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