Misdiagnosing Sneddon syndrome: Always look skin deep!!

We hereby present a case of a 41-year-old female with hypertension and right mastectomy, who presented with bilateral visual loss, weakness of all four limbs, and livedo reticularis of acute onset and was found to have multifocal areas of infarct in bilateral occipital lobes and left external capsule due to antiphospholipid syndrome. Various differentials in the form of sepsis-induced posterior reversible encephalopathy syndrome, posterior circulation stroke, and purpura fulminans confused the final diagnosis of an orphan disease – Sneddon syndrome. This case is reported for the rarity of the disease and the diagnostic dilemmas faced by the nondermatologist in diagnosing this condition even in the presence of striking skin changes.