What Does CMTC Look Like?

CMTC has a marble-like or lace-like pattern of blood vessels on the surface of the skin (Picture 1). This pattern looks similar to mottling of the skin seen in young infants when they are cold. However, in children with CMTC, the marbling is typically darker and does not go away when the child’s skin is warm.

CMTC can affect the arms, trunk and face, but most often occurs on the legs.

The marble-like skin pattern may involve large areas of the body (generalized CMTC, bottom left of Picture 2). It may be limited to a certain part of the body (localized CMTC, bottom right of Picture 2).

The marble-like pattern can appear more obvious with activity, crying, or when skin is exposed to the cold. There may also be slight depressions in the skin (fat atrophy). Bulging veins within the affected area are sometimes seen in individuals with CMTC.

How Is CMTC Diagnosed?

Physicians can recognize CMTC by the history and careful examination.

Diagnostic imaging tests may be advised if other concerns are suspected. These tests may include:

• X-rays
• Computerized tomography (CT)
• Magnetic resonance imaging (MRI)
• Ultrasonography (ultrasound)

What Are the Possible Complications of CMTC?

Serious complications are uncommon in CMTC. Reported issues associated with CMTC can include:

• Undergrowth or overgrowth of extremities with potential for limb length differences
• Body asymmetry (unevenness)
• Fat atrophy (dimpling of the skin) and ulceration of the skin
• Capillary malformations
• Macrocephaly (enlarged head size) and possible developmental delay
• Enlarged or prominent veins
• Congenital glaucoma (in those with facial involvement)
• Pain, heaviness, fatigue or tingling of affected extremity

What Is the Management of CMTC?

Most patients with CMTC show slow but gradual improvement with age. The mottled skin pattern begins lightening after birth with most change happening during the first year of life. Fading of the mottled skin pattern then slows down after the 1st birthday and may not be visible by 2-3 years of age. Sometimes, CMTC skin discoloration does not completely go away. Skin dimpling (fat atrophy) typically goes away before 1 year of age.

There is no specific treatment for CMTC. Many CMTC skin lesions need no treatment. If there is a particular cosmetic concern after the skin lesion has faded, then laser therapy may be used. If enlarged veins develop, a special compression garment may be recommended.

Due to the potential of other concerns, careful evaluation and follow-up are important. Some infants may require consultations with other pediatric specialists.