Image of cutis marmorata from the New England Journal of Medicine.
Kalentzos 362 (23): e67, Figure 1 June 10, 2010
 |
 |
Return to Article | |
|
|
Add to Personal Archive | |
|
|
PowerPoint Help |
A 38-year-old man was transferred to the Diving and Hyperbaric Medicine Unit with decompression sickness 9 hours after a deep scuba dive to 54 m (177 ft). During the ascent, he had omitted decompression stops. On physical examination, there was evidence of paraparesis, hypoesthesia, and urinary retention associated with spinal cord involvement, as well as a characteristic rash (cutis marmorata) on the thighs and torso. Cutis marmorata is a dermal manifestation of decompression sickness. Initially, there is erythema accompanied by pruritus, and then the rash spreads irregularly and deepens in color. It develops a mottled appearance, with areas of pallor surrounded by cyanotic patches. During recompression, the rash resolves. Although cutis marmorata is not directly associated with complications, it commonly accompanies or precedes more severe illness involving the central nervous system or cardiovascular system and should be identified early in a troubled diver. The patient was treated with recompression in a hyperbaric-oxygen chamber. He was discharged 20 days later with resolution of the rash and full recovery of motor function. On follow-up 6 months after discharge, he remained free of symptoms.