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[Painful cutis marmorata teleangiectatica congenita]
A Lentner1, U Böhler, C Wittkopf-Baumann
1Hautklinik, Medizinischen Fakultät, Rheinisch-Westflischen Technischen Hochule Aachen.
Summary
Cutis marmorata telangiectatica congenita (CMTC) can cause chronic pain due to increased nerve fibers in affected skin. Near-infrared venoscopy can help visualize associated vascular changes.
Area of Science:
- Dermatology
- Vascular Medicine
- Pain Management
Background:
- Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital vascular malformation.
- Chronic pain is a potential, though not widely reported, symptom associated with CMTC.
- Understanding the underlying pathophysiology of CMTC-associated pain is crucial for effective management.
Observation:
- A 39-year-old female patient with CMTC on her back reported a 5-year history of progressive pain.
- Pain initially triggered by touch and cold exposure, eventually becoming constant.
- Clinical examination revealed affected skin area with phlebectatic subcutaneous veins.
Findings:
- Histopathological analysis of a skin biopsy demonstrated an increased density of nerve fibers in the affected CMTC area.
- Near-infrared (NIR) venoscopy successfully visualized the dilated, phlebectatic subcutaneous veins, correlating with clinical observations.
- The combination of neuro-vascular findings suggests a potential mechanism for the chronic pain experienced by the patient.
Implications:
- This case highlights the importance of considering neuropathic components in CMTC-related pain.
- NIR venoscopy may serve as a valuable, non-invasive tool for assessing vascular abnormalities in CMTC.
- Further research into the neuro-vascular interplay in CMTC could lead to improved diagnostic and therapeutic strategies for pain management.