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Diseases of Infancy and Childhood
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Cutis marmorata is a reticulated, blanchable, violaceous mottling of the neonatal skin seen on the trunk and extremities. This phenomenon is a physiologic response of the neonate to cooling, which causes dilation of capillaries and venules. It rapidly disappears as the infant is rewarmed. Treatment is unnecessary. Its distinction from cutis marmorata telangiectasia congenita should be made, because the latter is a vascular malformation that persists for several years in the form of well-defined large patches.
Anti-Phospholipid Antibodies: Clinical Complications Reported in Medical Literature
Published in E. Nigel Harris, Thomas Exner, Graham R. V. Hughes, Ronald A. Asherson, Phospholipid-Binding Antibodies, 2020
Livedo reticularis, a cyanotic, geographically distributed “network” pattern of dilated superficial veins, often precipitated or aggravated by cold, may occur in normal children and adults (usually female). It is referred to as “cutis marmorata” and is caused by capillary stasis in areas of skin farthest from the cutaneous arteriolar blood supply. It occurs particularly on the lower limbs and has been described in many situations where stasis of blood in the superficial venous plexus of the skin might occur, such as in vasculitic conditions (e.g., polyarteritis nodosa) atheromatous vascular disease, or with certain blood disorders such as idiopathic thrombocythemia, TTP or polycythemia vera. It also occurs in the condition referred to as livedo vasculitis.23 It may also be seen with connective tissue disorders. It was first documented as occurring in SLE by Golden in 196324 and in 1984, Hughes first commented on the increased frequency of the condition in patients with SLE and aPL antibodies.25 Other authors have now confirmed this association.
Familial Dysautonomia
Published in David Robertson, Italo Biaggioni, Disorders of the Autonomic Nervous System, 2019
Autonomic dysfunction becomes apparent during the examination especially if the child is agitated, excessive sweating and blotching can then be noted. Distal vasoconstriction in the peripheral skin causes cutis marmorata accompanied by hypertension and tachycardia. In addition, the autonomic dysfunction is so generalized that it is easier to think of its effects within the various other systems.
Supraventricular tachycardia after respiratory syncytial virus infection in a newborn
Published in Baylor University Medical Center Proceedings, 2022
Seda Aydoğan, Nurdan Dinlen Fettah, Ali Ulaş Tuğcu, Ece Koyuncu, Tamer Yoldaş, Ayşegül Zenciroğlu
During follow-up, the patient’s heart rate increased from 132 beats/min to 260 beats/min, and he became restless. Physical examination at this time was normal except for tachycardia. No significant perfusion disorder was observed during the patient’s SVT attack. Only cutis marmorata was seen; hypotension did not develop. During tachycardia, the patient’s body temperature was 36.7°C, blood pressure was 70/42 mm Hg, and respiratory rate was 50 breaths/min. In the electrocardiogram taken during tachycardia, the heart rate was 264 beats/min, there were no p waves, and the R-R intervals were regular (Figure 1). The patient was diagnosed with SVT and administered adenosine 100 mcg/kg/dose intravenously as rapid division. A second dose of adenosine was administered when the SVT attack did not stop with the first dose. When the patient’s SVT attack did not respond to two doses of adenosine treatment, it was observed that his heart rate decreased to 152 beats/min after intravenous loading of amiodarone 5 mg/kg/dose for 30 minutes. No pathology was detected in his echocardiography. The patient underwent 24-hour Holter monitoring, and no recurrent SVT attack was found. There was a history of fetal arrhythmia during pregnancy.
Cutis marmorata telangiectatica congenita: a focus on its diagnosis, ophthalmic anomalies, and possible etiologic factors
Published in Ophthalmic Genetics, 2020
Matthew S. Elitt, Joan E. Tamburro, Rocio T. Moran, Elias Traboulsi
Cutis marmorata telangiectatica congenita (CMTC, OMIM #219250) is a sporadic, congenital disorder characterized by cutaneous vascular abnormalities that typically occur in a localized distribution (1). The first case was documented in 1922 by the Dutch female pediatrician Cato van Lohuizen (2), but only ~300 cases have been described since that time (3,4). The precise etiology of CMTC remains elusive, and various genetic and non-genetic mechanisms have been suggested (5). No defining histopathological features have been identified (6,7), and the diagnosis is currently based on its cutaneous clinical features (4,5). Unfortunately overlap of CMTC’s clinical signs with several other disorders, including Klippel-Trenaunay syndrome, and Sturge-Weber syndrome, present challenges for the diagnosing clinician (3,5). Additionally CMTC is quite rare, further complicating the development of a comprehensive profile of its clinical features – including its ocular abnormalities.
Cutis mormorata telangiectatica congenital successfully treated with intense pulsed light therapy: A case report
Published in Journal of Cosmetic and Laser Therapy, 2018
CMTC is a very rarely reported congenital vascular anomaly present at birth. Since the first case report by Von Lohuizen in 1922, more than 300 (3) cases have been reported worldwide to date. On reviewing the literature, it was found that there is no satisfactory treatment for this condition especially in ulcerative variety. Also cutis marmorata is a benign self-limiting condition and does not require treatment but in ulcerative variety because of severe pain life becomes miserable for the patient. There are reports of phakomatosis pigmentovascularis type II-associated CMTC responding to combination laser treatment using Q-switched Alexandrite and long-pulsed dye laser (3). On review of literature on IPL therapy in vascular anomalies, we found that IPL reduces the inflammation by downregulating TNF-alpha (4). IPL enhances transforming growth factor beta1/smad3 signaling pathway (5), thereby inducing synthesis of dermal extracellular proteins in vitro (6). IPL also increases the content of dermal collagen and elastic fibers (7). All these factors help in reducing the inflammation as well as reduction of scarring, which was evident in our results of the therapy. IPL does help in correcting the dilatation of capillaries (8) by using vascular filter of wavelength 550–1200 nm. IPL therapy was started in this vascular anomaly because histologically it showed classical dilatation of capillaries in the dermis. IPL is also used in the erythematotelangiectatictype of rosacea (9,10,11) where it helps not only in reducing blood flow but also reduces the area of telangiectasia and thereby reducing erythema. It also helps in improving the skin texture. Schroeter and Neumann (12) and later on Angermeirer (13) and Bjerring et al. (14) confirmed the use of IPL in facial telangiectasias. Clementoni et al (15) reported 87% of patients showed 75–100% clearance in facial telangiectasia. With the help of these reviews on IPL in the treatment of telangiectasia, this technology was used in treating CMTC with excellent result (Figure 4c).