Neonate with Marbled Skin Appearance
Manoj Kumar Jangid
Department of Neonatology, Farwania Hospital, State of Kuwait
Address for Correspondence: Dr Manoj Kumar Jangid {M.D.}, Registrar, Department of Neonatology, Farwania Hospital, State of Kuwait. Email: drmanojjangid@gmail.com

A full-term male neonate born of non-consanguineous parents was noticed to have reticulated skin lesions involving the whole body two hours after birth. Baby cried immediately after birth and birth weight was 3.7 Kg. Antenatal period was unremarkable. Physical examination showed a reticulated marbled reddish-purple hue pattern over the trunk, extremities and face sparing the palms and soles, resembling physiological cutis marmorata but was more pronounced and was unvarying in nature {Fig.1}. Rest of the systemic examination was unrevealing.

What is the diagnosis___?
 
Cutis marmorata telangiectasia congenita {CMTC}, also called Von Lohuizen syndrome or congenital generalized phlebectasia is a rare, benign, sporadic skin lesion that presents at birth or shortly thereafter as a localized or generalized, reticulated, blue-violet, cutaneous vascular network. {1,2} CMTC is a clinical diagnosis and histopathological examination of skin is usually not diagnostic. In contrast the physiological cutis marmorata tends to disappear with rewarming and is not persistent. The other differential diagnosis includes conditions such as Klippel-Trenaunay-Weber Syndrome, neonatal lupus erythematosus, nevus anemicus, livedo reticularis associated with collagen vascular disorder, nevus flammus, and diffuse phlebectasia. {3}Sometimes CMTC may be complicated with other associated anomalies, for example, macrocephaly, superficial ulceration, glaucoma, hypospadias, syndactyly, multicystic renal disease and cardiac malformations. {4} The disorder is self-limiting and prognosis is usually good and the lesions mostly improve within 2 years after birth. There is actually no specific treatment for the lesions but the laser therapy is under investigation. {3}

References
1. Kienast AK, Hoeger PH. Cutis marmorata telangiectatica congenita: a prospective study of 27 cases and review of the literature with proposal of diagnostic criteria. Clin Exp Dermatol. 2009` 34: 319-323.
2. del Boz Gonzalez J, Serrano Martin MM, Vera Casano A. {Cutis marmorata telangiectatica congenita. Review of 33 cases}. An Pediatr {Barc}. 2008` 69: 557-564.
3. Chatterjee R, Dey S. Cutis marmorata telangiectatica congenita with skin ulcerations in a new born. Indian J Dermatol. 2009`54: 375-377.
4. Anand NK, Pannu MS, Singh P. Cutis marmorata telangiectatica congenita. Indian Pediatr. 2002` 39: 203.

E-published: October 2012 Vol 9 Issue 10 Art # 68

DOI No. : 10.7199/ped.oncall.2012.68
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