Cutis marmorata telangiectatica congenita (CMTC)

This information sheet from Great Ormond Street Hospital (GOSH) explains the causes, symptoms and treatment of cutis marmorata telangiectatica congenita (CMTC) and where to get help. Cutis marmorata telangiectatica congenita (CMTC) is a birthmark that affects the blood vessels in the skin causing a net-like pattern on the skin giving a ‘marbled’ appearance.In most cases, CMTC does not cause any problems and the skin marbled appearance fades in early childhood.

C utis = skin
M armorata = marbled
T elangiectatica = blood vessels like thread veins
C ongenita = present at birth

We do not fully understand what causes CMTC. It probably develops early in fetal life when the blood vessels are forming. It is not passed on from parent to child. It is unlikely to have been caused by anything that happened during pregnancy. It is a rare condition.

The main feature of CMTC is the net-like pattern on the skin, which gives a marbled appearance. This pattern ranges in colour from blue to purple and may become more visible in extremes of temperature. The pattern may affect one area of the body – most commonly a leg, but sometimes also the arms and trunk. The pattern rarely affects the face and scalp.

In most cases, the condition causes no problems and is not painful. Very rarely, part of the affected skin may bleed or break down, which may be painful. Occasionally, CMTC can be associated with other problems such as a difference in growth rate of the affected limb.

The net-like pattern is visible soon after birth. Although the net-like pattern is distinctive, imaging scans such as x-ray, CT or MRI may be suggested to confirm or rule out other conditions that have similar features. On the rare occasions where the skin of the face and scalp is affected, children should have a specialist eye and neurological examination to check for any associated problems.

In most cases, treatment is not required as the net-like pattern fades within the first few years of life. If areas become ulcerated, these will need special dressings to help them heal. If bleeding is a problem laser treatment may be required.

Depending on any associated features, the outlook for children with CMTC is good, with the symptoms improving during early childhood.