Atypical distally distributed cutis marmorata decompression sickness associated with unconventional use of thermal protection in a diver with persistent foramen ovale

Cutis marmorata is a mottled, marbling, livedoid rash caused by vascular inflammation and congestion in cutaneous decompression sickness. It may occur during or after ascent due to the formation of bubbles from dissolved nitrogen accumulated throughout the dive. It is strongly associated with the pr...

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Published in:Diving and hyperbaric medicine 2023-09, Vol.53 (3), p.285-289
Main Authors: Magri Gatt, Petra, Diacono, Emily, Matity, Lyubisa, Magri, Kurt
Format: Article
Language:English
Subjects:
Decompression Sickness - complications
Decompression Sickness - therapy
Diving - adverse effects
Exanthema
Foramen Ovale, Patent - complications
Humans
Livedo Reticularis
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creator Magri Gatt, Petra
Diacono, Emily
Matity, Lyubisa
Magri, Kurt
description Cutis marmorata is a mottled, marbling, livedoid rash caused by vascular inflammation and congestion in cutaneous decompression sickness. It may occur during or after ascent due to the formation of bubbles from dissolved nitrogen accumulated throughout the dive. It is strongly associated with the presence of right to left shunts, particularly persistent (patent) foramen ovale (PFO). We report a case of cutis marmorata decompression sickness of an unusual pattern associated with unconventional use of thermal protection (a 'shorty' wetsuit worn over full suit) by a diver with a PFO. The patient also had neurological manifestations of decompression sickness. The distal lower limb pattern of involvement favours the hypothesis that cutis marmorata in humans is likely to be due to bubbles in the skin itself and/or adjacent tissues rather than cerebrally mediated.
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subjects Decompression Sickness - complications
Decompression Sickness - therapy
Diving - adverse effects
Exanthema
Foramen Ovale, Patent - complications
Humans
Livedo Reticularis
title Atypical distally distributed cutis marmorata decompression sickness associated with unconventional use of thermal protection in a diver with persistent foramen ovale
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