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Cutis Marmorata

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Figure 23-1

Cutis marmorata This term means “marbled skin” and is intended to describe the appearance of the skin in which the terminal vessels are so superficial and dilated that they are constantly visible in patterns that vaguely suggest veined marble. This condition is physiologic in the newborn and represents a vasomotor response to lowering of the environmental temperature. Persistent cutis marmorata is seen in Down syndrome and in trisomy 18.

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Cutis Marmorata Telangiectatica Congenita

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Figure 23-2

Cutis marmorata telangiectatica congenita This condition is present at birth and consists of accentuated vascular markings (cutis marmorata), along with areas of telangiectasia, and occasionally ulceration, and atrophy. The lesions may be localized, usually to a lower extremity or generalized.

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Figure 23-3

Cutis marmorata telangiectatica congenita A small minority of children with this condition have other abnormalities, including hemiatrophy or hemihypertrophy. The mottling resolves gradually with age in most patients.

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Livedo Reticularis

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Figure 23-4

Livedo reticularis Livedo means a slate-gray blueness. Reticularis means “like a net.” The term describes a network of gray-blueness that is generally seen on the lower extremities. The idiopathic form of this disorder, most common in young women, carries a good prognosis. However, livedo reticularis is also seen in association with polyarteritis nodosa, SLE, and cryoglobulinemia.

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Nevus Simplex (Salmon Patch)

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Figure 23-5

Nevus simplex (salmon patch) Nevus simplex is by far the most common vascular lesion in the newborn. This midline or symmetrical pink macular lesion is most commonly seen on the eyelids, the nape of the neck, and the glabella. The last two are commonly described as “stork bite” and “angel’s kiss,” respectively. The glabellar lesion in Fig. 23-5 can be expected to resolve spontaneously, as do lesions on the eyelids. Rarely, a nevus simplex on the neck may persist into adult life.

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Port-Wine Stain

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Figure 23-6

Port-wine stain This unilateral vascular malformation has a markedly different histology, significance, and natural history from that of the nevus simplex. The port-wine stain is made up of capillary ectasias that may be present throughout the dermis and that gradually increase with age. The color may change from pink to purple as the patient grows, and the lesions may become nodular during adult life. Because port-wine stains show no tendency to involute, they may represent a significant, lifelong cosmetic problem.

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