Cutis marmorata is a common skin condition often seen in newborns and children. It appears as a pinkish-blue mottled pattern, usually in response to cold temperatures. While it is common in infants and children, it can also occur in adults.

Cutis marmorata, also called livedo racemosa, is a benign (noncancerous) condition that does not lead to any complications and does not require treatment.

Occasionally, cutis marmorata can be seen in decompression sickness, sometimes experienced by scuba divers. In these cases, it will be associated with additional symptoms.

Read on to learn more about cutis marmorata, what it looks like, and what causes it.

Cutis marmorata is a condition that causes temporary skin discoloration.

It tends to appear as a bluish red or pink color in a lacy or marbled pattern. In people with darker skin tones, the rash will appear as a marbled or lacy dark brown or purplish color.

The discolored skin is not itchy and doesn’t hurt. It appears in response to cold temperatures. Once the skin warms, the symptoms usually disappear.

Cutis marmorata generally appears on the arms and legs, but it can also appear on the trunk (torso) of the body.

Cutis marmorata looks slightly different when it’s a symptom of decompression sickness, which can affect scuba divers. In this case, it might present with a less regular pattern in some areas of the body. Cutis marmorata may also itch when it’s caused by decompression sickness.

Cutis marmorata is not the same as a very rare genetic condition called cutis marmorata telangiectatica congenita (CMTC).

CMTC is most often present at birth and does not go away with temperature changes. Occasionally, CMTC can be accompanied by skin ulcers and the appearance of “spider veins.”

Like cutis marmorata, CMTC is often benign and typically goes away in the first few years of a child’s life. However, though it’s rare, it’s possible for infants with CMTC to have some lasting irregularities.

The exact cause of cutis marmorata isn’t fully known.

The skin mottling associated with cutis marmorata is caused by small blood vessels at the surface of the skin expanding and contracting at the same time in response to temperature. However, it is not known why some people develop this and others do not.

Children with certain diseases may have a higher incidence of cutis marmorata. These include:

Cutis marmorata in newborns

Cutis marmorata is very common in newborns. It’s estimated that most newborns and up to 50 percent of children will experience cutis marmorata at some point. Many episodes of cutis marmorata resolve quickly.

This discoloration is more commonly seen in premature babies.

In infants, cutis marmorata is often thought of as a normal physiological response to cold temperatures. This is because infants’ nerves and blood vessels aren’t yet fully developed.

When their skin cools, the blood vessels near their skin’s surface can contract and dilate. This can lead to the skin discoloration seen in cutis marmorata.

Cutis marmorata in adults

There isn’t a known cause of cutis marmorata in adults. It’s thought that it might be caused by factors such as:

  • diet
  • viral infections
  • genetic differences

Additionally, adults who experience decompression syndrome can sometimes develop cutis marmorata (livedo racemosa), likely due to air bubbles in a blood vessel.

This will also be associated with other symptoms of decompression syndrome, such as:

  • itching
  • confusion
  • pain in muscles and joints
  • extreme fatigue

Decompression syndrome can occur when the pressure around your body changes rapidly, such as when you come up from an underwater dive too quickly.

Cutis marmorata in decompression sickness

The commonly accepted explanation for cutis marmorata in decompression sickness is that gas bubbles form in the blood vessels. However, there are other theories.

A 2015 study proposed that the mottling of the skin in decompression sickness may be caused by damage to the brain.

Another 2015 study suggested that gas bubbles damage the brain stem. This affects the part of the nervous system that regulates the dilation and contraction of blood vessels.

Here are some images of cutis marmorata in infants and adults.

Cutis marmorata is considered benign in all age groups. Treatment is only needed if symptoms cause discomfort or distress.

Warming the skin usually makes the signs of cutis marmorata disappear. In infants, the symptoms tend to resolve on their own within a few months to a year.

Cutis marmorata in decompression sickness is usually one of several severe symptoms involving the central nervous system or the heart. Treatment depends on the severity of the symptoms and often includes recompression in a hyperbaric oxygen chamber.

Cutis marmorata rarely has any complications. However, the condition can look similar to other skin conditions that may have complications.

Additionally, a cutis marmorata-like skin mottling that doesn’t go away when a child’s skin is warm might actually be a sign of a more serious condition, such as sepsis or congenital hypothyroidism, in an infant.

If your child’s skin mottling doesn’t improve with warmer temperatures, talk with a doctor to determine the cause.

Cutis marmorata is a mottled skin pattern that’s most common in newborns.

Generally, this condition is temporary and resolves on its own within the first 2 years of a child’s life. Most children don’t need any treatment for this condition.

Cutis marmorata can also occur in adults. It rarely needs treatment and is generally considered benign, no matter your age. Sometimes, it can be seen in people with decompression sickness, a serious condition that needs advanced treatment.

It’s possible for cutis marmorata to look similar to other more serious skin conditions. If the skin discoloration doesn’t fade when warmed, it’s best to go to a doctor for a medical diagnosis.