Overview

Cutis marmorata is a reddish-purple mottled skin pattern common in newborns. It appears in response to cold temperatures. It’s usually temporary and benign. It can also occur in children, adolescent girls, and adults.

Read on to learn more about this condition and its complications.

Symptoms

Cutis marmorata symptoms for infants, children, and adults are alike. They include a lacy, symmetrical flat pattern on the skin that’s reddish-purple in color, alternating with pale areas. The discolored area is not itchy and doesn’t hurt. It should disappear as the skin becomes warmer.

In infants, cutis marmorata is usually on the trunk and limbs. It often stops occurring as the child ages.

Adults who experience decompression illness, such as scuba divers, may have a less regular pattern in some areas of the body. Their cutis marmorata may also be itchy.

Pictures of cutis marmorata

Causes

The cause of cutis marmorata isn’t well understood. It’s generally considered to be a normal physiological response to cold temperature. In newborns and infants, it may result from their undeveloped nerve and blood vessel systems.

The general explanation is that when the skin cools, the blood vessels near the surface contract and dilate alternately. The red color is produced when the vessels expand and the pale part is produced when the vessels shrink.

Cutis marmorata in decompression sickness

The commonly accepted explanation for cutis marmorata in decompression sickness is that gas bubbles form in the vascular system. There are other possible explanations, however. A 2015 study proposed that mottling of the skin in decompression sickness may be caused by damage to the brain. Another 2015 study suggested that gas bubbles damage the brainstem. This affects the part of the nervous system that regulates the dilation and contraction of blood vessels.

Incidence and risk factors

Cutis marmorata is very common in newborns. It’s estimated that most newborns and up to 50 percent of children have cutis marmorata. However, a 2011 Brazilian study of 203 newborns found a much lower incidence. In this study, only 5.91 percent of light-skinned babies had cutis marmorata.

It’s more commonly seen in premature babies.

Children with some diseases tend to have a higher incidence of cutis marmorata. These include:

Cutis marmorata is also a symptom of decompression sickness. Divers and people who work in some underground infrastructure projects in compressed air are at risk for cutis marmorata as one of their symptoms. A 2015 study found that fewer than 10 percent of divers with decompression illness had cutis marmorata.

Treatment

Warming the skin usually makes cutis marmorata disappear. No additional treatment is necessary unless there’s an underlying cause for the mottling.

In infants, the symptoms usually stop occurring within a few months to a year.

Cutis marmorata in decompression sickness usually accompanies more 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.

Complications

Cutis marmorata is usually a benign condition in newborns and infants, with no complications.

If the mottling persists and if warming the child doesn't stop the mottling, it may be caused by an underlying condition. For example, cutis marmorata may be an early warning sign of sepsis in an infant. It could also be a sign of congenital hypothyroidism. If the mottling persists, take your child to the doctor to get a diagnosis.

Cutis marmorata should be distinguished from the similar, but more pronounced, skin pattern of livedo reticularis. This is also known as cutis marmorata telangiectatica congenita. It’s a rare congenital condition and usually benign, but may be associated with abnormalities. There are fewer than 300 cases reported in the medical literature. Check out other causes for mottled skin.

Outlook

Cutis marmorata is a common and temporary condition in healthy infants. It usually stops occurring within months. Rarely, it may point to another underlying condition.

As a symptom of decompression illness, it’s temporary and can be treated.