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Cutis marmorata

Cutis marmorata is a condition where the skin has a pinkish blue mottled or marbled appearance when subjected to cold temperatures. It occurs in about 50% of children and is typically seen throughout infancy. Adults may also be affected. Rewarming usually restores the skin to its normal appearance.

Cutis marmorata telangiectatica congenita (CMTC) is a distinct vascular disorder that typically presents at birth or shortly thereafter. It has the same appearance as cutis marmorata and is more prominent in cold climates. However, improvement does not always occur with rewarming.

The mottled appearance is caused by superficial small blood vessels in the skin dilating and contracting at the same time. Dilation creates the red colour of the skin whilst contraction produces a pale appearance. This phenomenon is most pronounced when the skin is cooled. Reasons why this happens is not fully understood but the following factors may be involved:

- Genetics
- External factors, including viral infection
- Defect in embryonic skin development

Although CMTC is a very rare disorder, 50% of these patients have one or more other associated congenital skin conditions. These include:

- Haemangiomas
- Capillary vascular malformations
- Glaucoma
- Skin atrophy (thinning) and ulceration

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