By Gary M. White, MD
Macular lymphocytic arteritis (MLA), also known as lymphocytic thrombophilic arteritis, is a rare cause of pigmented macules on the legs of women. It may be a minor variant of polyarteritis nodosa.
Characteristic are multiple erythematous to hyperpigmented macules on the lower legs of a middle-aged woman. Livedo reticularis may also be seen. The lesions are usually asymptomatic and there is usually no progression of the disease.
Lab work is often positive for an elevated erythrocyte sedimentation rate and antinuclear antibody titers. Occasionally anticardiolipin antibodies, factor V Leiden mutations, and prothrombin gene mutations are present.
No good and reliable treatment is available. Topical steroids do not seem to be of much help.