Cutis Marmorata Telangiectatica Congenita (CMTC)

Cutis marmorata telangiectatica congenita (CMTC) is a rare condition that mainly affects the blood vessels of the skin. It is usually seen at birth or soon after.

CMTC appears as marble-like pattern on the surface of the skin, called mottling. This purplish pattern is similar to the fishnet-like blotches seen in young infants when they are cold. In children with CMTC, the marbling is more severe and always visible.

Localized CMTC.

The marble-like skin pattern may be limited to a certain part of the body (localized CMTC, above) and there may be slight depressions in the skin.

Generalized CMTC.

CMTC also may spread over large areas of the body (generalized CMTC, above).

CMTC can affect the arms, trunk and face, but usually occurs on the legs. The marble-like pattern can get larger with vigorous movement, crying, or when skin is exposed to the cold.

The exact cause of CMTC is unknown. The disorder is not usually seen in more than one family member. 

Some researchers think it may be caused by a specific type of genetic condition.  Others think that the building blocks affecting the development of blood vessels in the womb are involved. 

CTMC is most likely not caused by any medication taken during pregnancy or any activity performed during this time.

CMTC can be associated with other conditions. Related abnormalities are found in up to 50 percent of patients with CMTC. These abnormalities include vascular conditions such as capillary malformations (oddly shaped patches that look like birthmarks) as well as a large number of other conditions including:

  • Overgrowth or undergrowth of extremities
  • Body asymmetry
  • Problems with teeth
  • Glaucoma (increased pressure of the fluid within the eye)
  • Delayed development
  • Macrocephaly (enlarged head size)

Physicians can recognize CMTC by careful examination and observation of a specific clinical area. Most important, they can tell if a patient has CMTC or some other vascular condition.

Diagnostic imaging tests are advised only when other abnormalities are suspected. These tests may include:

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

Most patients with CMTC show gradual but definite improvement with age. The most noticeable change occurs during the first year of life. Fading of the mottled skin pattern then slows down, but continues as the skin matures and thickens.

Since the marble-like skin pattern fades on its own, no special treatment for CMTC is needed. However, laser therapy may be used after the pattern has faded in order to destroy the abnormal blood vessels if there is a cosmetic issue.

Due to the incidence of other related conditions, careful evaluation and follow-up are important, and some infants require consultations with other pediatric specialists.

Last Updated 12/2013