Cutis marmorata telangiectatica congenita: a rare vascular m
The present case appears in BMJ.

A 5-day-old female baby was born at term following an uneventful pregnancy. At birth, she weighed 2800 g, and her growth profile was appropriate for her age. Her general physical examination was unremarkable except for the appearance of a 3×4 cm bluish-purple skin lesion over the right knee. The skin lesion had erythematous reticulated appearance at the periphery and ulceration at the centre with subcutaneous atrophy.

There was no limb asymmetry, other vascular lesions, bony defects or ocular malformations. The ulceration over the right knee healed with local antibiotic ointment application. Her cranial ultrasound and eye examination were normal.

When the infant’s reticulated lesion over the right knee was re-examined at 6 months of age, it has markedly reduced in size with an observed puckered scar. There was marked subcutaneous atrophy around the scar, and the joint mobility around her knee was unrestricted.

At 4 years old, only a fading purplish reticulated lesion with minimal subcutaneous atrophy was observed over the right knee. The child was able to ambulate normally, and she achieved age-appropriate growth parameters and developmental milestones.

Learning points
• Cutis marmorata telangiectatica congenita (CMTC) is a benign rare vascular anomaly often noted in the newborn period. It is a self-limiting disorder without associated anomalies, and its recovery is expected within the first 2 years of life.

• Diagnosis is clinical, and there is no gold standard for diagnosis of CMTC, but there are diagnostic criteria available, which can be used to distinguish CMTC from cutis marmorata and other vascular malformations.

• Associated anomalies are seen in more than half of the cases of CMTC, and they include mostly limb asymmetry and eye lesions. Less often lesions in the brain, bone, kidney, heart and angiomatous malformations (port-wine stain, haemangioma and lympangioma) are reported.

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