Livedoid dermatitis is a iatrogenic cutaneous reaction that occurs immediately after a drug injection.

It presents as an immediate, extreme pain around the injection site, with overlying skin rapidly becoming erythematous, violaceous, or blanched ("ischemic pallor")[1]: 124  and sometimes with reticular pattern.

The reaction eventually leads to variable degrees of necrosis to the skin and underlying tissue.

[5] Livedoid dermatitis has been reported to occur with many different drug injections, including: penicillins, local anesthetics (e.g. lidocaine), vaccines (e.g. Dtap), corticosteroids, NSAIDs, and more.

Microscopic examination of affected tissue shows ischemic necrosis,[7] and so various hypotheses exist to explain this ischemia, including vasospasm from needle prick, the injected drug, or cold compresses applied to the wound.