Sometimes, a condition has a name that’s much scarier than the problems it causes. That’s usually the case with cutis marmorata telangiectatica congenita, or CMTC.
CMTC is a rare disease. It causes a blue or purple pattern on the skin that looks marbled or like fishnet. It generally shows up at birth or shortly after. Most often, it doesn’t need treatment and is just an issue of looks. It gets better as your child gets older.
The pattern is formed by blood vessels near the skin that are wider than normal, but doctors don’t know what causes it. Once in a while, another family member also has CMTC, but that’s not typical. More often, it happens at random, and it doesn’t seem that anything during pregnancy triggers it.
What Are the Symptoms?
The main sign is the blue or purple marbled pattern on the skin. It looks a lot like what happens to a baby’s skin when they’re cold, but it’s more defined and doesn’t go away.
Most children get it on the legs, but it can happen on the arms, torso, or very rarely, the face and scalp. The pattern may get larger when your child moves, cries, or gets cold.
It doesn’t happen often, but CMTC can also cause:
- Bleeding on areas of the skin where the pattern appears, sometimes along with pain
- Slower or larger growth of the limb that has the pattern
Does It Cause Any Other Problems?
This is a much harder question to answer. CMTC is rare and doctors are always learning more about it.
It’s not common, but because CMTC may affect growth of the limb where it appears, your child could have one leg or arm that’s longer than the other. Some children with CMTC in their legs also get superficial venous insufficiency -- that’s where the veins in the legs have trouble pushing blood back up to the heart.
Beyond those two problems, it’s less clear.
In the past, it looked like children with CMTC were also sometimes born with issues ranging from pressure buildup in the eye (glaucoma) to muscle loss. But more recent studies seem to show that these children don’t have CMTC. Instead, they have other conditions such as Klippel-Trenaunay syndrome and Cowden's disease.
How Will My Doctor Test For It?
Your doctor will talk to you about your child’s health history and do a physical exam. That’s typically enough to know if it’s CMTC. If your doctor thinks there’s a different problem, your child may get some imaging, such as an X-ray, CT, or MRI.
If CMTC shows on the face or scalp, your child may get an eye exam and a neurological exam, which checks to make sure their brain, nerves, and spinal cord work as normal.
How Is It Treated?
Often, children with CMTC don’t need treatment and the skin pattern goes away on its own. Usually, the pattern fades the most by the time your child is one, and it will continue to fade as your child’s skin thickens. In many cases, it’s gone within the first few years of life. And once it fades, it doesn’t come back.
Even without treatment, you’ll likely have regular visits with your doctor to keep an eye out for any issues. This is especially important since doctors are always learning about CMTC and similar diseases.
Your child may need treatment in the following cases:
- CMTC is on the face or scalp
- Leg, knee, or hip pain, or other signs that the legs are growing at different rates
- Pattern bleeds, grows, or causes pain
- Signs of superficial venous insufficiency
Your doctor will recommend a plan to treat these or any other symptoms. For example, if your child has bleeding, you’ll get special bandages for it. If that happens a lot, they may get treated with a device called a pulse dye laser. It destroys the blood vessels that cause problems even after CMTC has faded. It’s very effective, doesn’t harm the skin, and usually doesn’t cause scars.
Also, CMTC may create some anxiety for you and your child. The pattern may not fade completely, and that can be hard on an older child if it’s easily seen, especially on the face or neck. Your doctor can help you find a counselor to support your family.