Cutis marmorata telangiectatica congenita (CMTC)

It can be hard to find accurate information about cutis marmorata telangiectatica congenita (CMTC) because it’s such a rare condition. Here at Children’s Hospital Boston, we understand the condition—both what it is and what it’s not—and we know when and how to treat it.

The bottom line: It may seem scary at first, but CMTC usually gets better on its own—and your child should go on to live a normal, healthy life.  Read on to learn more about how our doctors diagnose CMTC and help you decide whether your child needs treatment for this rare condition.

What causes cutis marmorata telangiectatica congenital?

No one really knows what causes cutis marmorata telangiectatica congenita.

How common is it?

It’s very rare. Since the condition was named in 1970, only around 100 cases have been reported in the United States.

When does it appear?

If your baby has CMTC, it’s obvious at birth.

Is my child’s birthmark painful?

No. The only time it might be painful is if there’s any bleeding.

Signs and symptoms

What are the signs of CMTC?

The only sign of CMTC is the birthmark itself.  It’s a deep purple, net-like staining pattern that usually appears on your child’s trunk or legs.

Are there any symptoms of CMTC?

Not usually—it’s primarily a cosmetic concern. Sometimes kids with CMTC are more affected by cold temperatures than other kids. The birthmark often becomes more prominent during cold weather.

There are a few other rare symptoms:

• ulceration (bleeding) of the areas of the skin where the birthmark appears
• undergrowth of the limb where the birthmark appears can result in your child’s legs having different lengths, which could lead to trouble and/or pain with walking

Don't worry too much, though: These symptoms occur in less than one percent of children with CMTC.

Long-term outlook

What is the long-term outlook for my child?

CMTC typically goes away on its own. Your child may have some telangiectasias (small, dilated blood vessels) left after the birthmark has faded, but these can be treated with pulsed dye laser. Read more about laser therapy at Children’s.

You may have heard that CMTC sometimes affects the growth of your child’s limb (usually the leg), causing one leg to grow faster or slower than the other. While this can be true, the good news is that it doesn’t affect very many kids with CMTC—and if your child does end up with a difference in the length of her legs, our expert orthopedists can help correct the problem.

Can CMTC come back after it fades?

No. Once your child’s birthmark fades, it’s gone for good. As we said earlier, there may be some residual telangiectasias or dilated veins, which can be treated with laser therapy.

FAQ

Q: What is cutis marmorata telangiectatica congenita (CMTC)?
A: CMTC is a distinctive deep purple, net-like mark that is present on your baby’s skin at birth. It usually appears on the trunk and limbs.

Q: Does it get better?
A: It does. The birthmark will fade substantially over the first year of your child’s life as his skin strengthens and matures.

Q: Are there any symptoms of CMTC?
A: Not usually—it’s primarily a cosmetic concern. However, kids with CMTC are sometimes more affected by cold temperatures than other kids. The birthmark often becomes more prominent during cold weather.

There are a few other rare symptoms:

• ulceration (bleeding) of the areas of the skin where the birthmark appears
• undergrowth of the limb where the birthmark appears
  • can result in your child’s legs being two different lengths, which could lead to trouble and/or pain with walking

Don't worry too much, though: These symptoms occur in less than one percent of children with CMTC.

Q: Is it painful?
A: No. The only time the birthmark might be painful is if there’s any bleeding.

Q: What is the long-term outlook for my child?
A: CMTC typically gets better on its own. Your child may have some telangiectasias left after the birthmark has faded, but these can be treated with a pulsed dye laser. For more information about laser therapy, see the Treatment & Care section.

Q: How do I know if my child has CMTC?
A: A physician experienced in diagnosing birthmarks can tell you whether your child has CMTC just by examining the affected area.

Q: How is CMTC treated?
A: Usually, we don’t treat CMTC at all. The purple, marble-like pattern fades on its own over the first year as your child’s skin matures and thickens. Your child’s doctor will probably recommend observation after making sure that no other abnormalities are present.

Q: What are our options for cosmetic treatments?
A: Having a birthmark can be psychologically or socially difficult, and you may decide that—after it’s faded—you’d like to treat your child’s CMTC with laser therapy.

At Children’s, we use a device called a pulsed dye laser to destroy the telangiectasias that remain after the CMTC has faded. Pulsed dye laser is the gold standard of treatment for telangiectasias because it is highly effective and rarely causes any scarring.

Q: What makes Children’s different?
A: Our physicians are bright, compassionate and committed to focusing on the whole child, not just his condition. That’s one reason we’re frequently ranked as a top pediatric hospital in the United States.

We’ve also got the world’s largest Vascular Anomalies Center, home to specialists who diagnose and treat more rare vascular conditions than at any other hospital.

Questions to ask your doctor

It can be difficult to remember all the questions that you want to ask your child’s doctor at the appointment, and many parents find it helpful to jot them down. Here are some to get you started:

• What kind of birthmark does my child have?
• Could it be serious?
• Is there anything we should watch for?
• What treatments are available for removing the birthmark, if appropriate?