Chemical Lumbar Sympathectomy in the Treatment of Idiopathic Livedo Reticularis

In a study with 10 female patients, chemical lumbar sympathectomy (CLS) was evaluated as a treatment for idiopathic livedo reticularis (LR). The procedure involved injecting 5% phenol at the L3-4 level to target the gray rami communicans. Results showed that 7 patients had clear or almost clear resolution of LR lesions, 2 had major partial resolution, and 1 had minor partial resolution, with an increase in skin surface temperature of 7.4°C ± 2.6°C post-treatment. Two patients experienced recurrence within a year but achieved clear results again after repeating CLS. Only mild pain was reported as an adverse event. The study concluded that CLS is a valid, safe, and repeatable treatment for idiopathic LR, with long-lasting effects. The authors recommend targeting the gray rami communicans for effective sympathetic interruption.