Cutis Marmorata

The children pictured here have cutis marmorata--a condition seen mostly in newborns and infants, particularly after exposure to cold. The skin of this 2-week-old boy's legs and trunk (A) displayed the typical reticular reddish blue mottling caused by vasoconstriction and by low environmental temperatures.

The lacy network of small blood vessels seen on this 2-month-old girl's face and forearm (B and C) is an exaggerated physiologic response to chilling that produces vasospasm of small arteries, with subsequent hypoxia and dilation of venules and capillaries. Livedo reticularis has the same clinical picture but, unlike cutis marmorata, the mottling does not disappear when the skin is warmed.

Cutis marmorata usually is benign, tends to disappear as the infant grows older, and requires no treatment. Persistent and pronounced cutis marmorata can occur in hypothyroidism, Down syndrome, trisomy 18 syndrome, and de Lange syndrome.

(Case and photograph A courtesy of Alexander K. C. Leung, MD, and Matthew C. K. Choi, MD; case and photographs B and C courtesy of Robert P. Blereau, MD.)