Clinical Features of the "Skin Bends" and "Creeps" (Type I Skin Decompression Sickness,Cutis Marmorata)

 

Pathophysiology: small gas bubbles in skin capillaries and lymphatics

 

Clinical findings:

(1) pruritis of the ears, trunk and upper extremity ("the creeps")

(2) scarlatiniform rash

(3) truncal peau d'orange

(4) mottling or marbling of the skin (cutis marmorata)

(5) pitting edema

 

Management:

(1) when associated with altitude-related DCS this is usually transient and benign.

(2) when associated with diving-related DCS it often precedes more severe disease and should result in hyperbaric therapy.

 

Differential diagnosis:

(1) livedo reticularis