DCS or just a Skin Rash?
Returning from a scuba dive at the Blue Hole on Gozo, all is well and you feel great. As the day continues you develop a skin rash. It appears to be small and localised on the trunk of your body. Skin rashes appear not only on our torso they are found on the arms, legs and face. Popping the question, “what is that”? The usual answer is “no worries; it’s just from the sun” Remember, Cutis Marmorata is a DCS Type l condition!
The skin develops a blotchy colour, very much the colour and design of marble stone. The name ‘Marmorata’, actually means ‘marbling.’ The skin appears to have a red-bluish discolouring and causes itching and or slight pain to the patient. Skin colouration allows divers to believe they have a sun or a neoprene allergy. This results in no treatment at the onset of the sickness.
DCS – Decompression Sickness.
Cutis Marmorata is a mild form of decompression sickness (DCS). Without treatment, it leads to DCS Type ll. This skin rash serves as a warning signal to scuba divers that something is not quite right. The treatment for Cutis Marmorata is through inhalation of pure oxygen at the hyperbaric unit. Cutis Marmorata does not require hyperbaric recompression treatment. A physician monitors the patient after oxygen therapy to ensure that the Marmorata is retreating.
Parallels to other complications.
Study shows Cutis Marmorata patients often have undiscovered PFOs. This is not always the case for each individual. On rare occasions Cutis Marmorata is accompanied by other symptoms of DCS, vertigo, abnormal fatigue and clumsiness can be a symptom. Lacking concentration and visual distortion can be noted in Cutis Marmorate patients.
Patent Oval Foramen Ovale.
Observations show a patient suffering from Cutis Marmorata often have an undiscovered Patent Oval Foramen Ovale (PFO). Tests carried out on the body in relation to the Marmorata and the PFO will be discovered using a contrast echocardiography technique. Confirmation of the diagnosis, a ‘hole in the heart’ is quite shocking, it can be closed these days with surgery.
The Hypothesis of Cutis Marmorata.
Believed to be a collection of gas bubbles building up and cause a mild form of embolism to the brain stem. The brain stem is our main site of the nervous system that regulates our skin blood vessel constriction and dilation. Studies and observation now show Cutis Marmorata is decompression sickness. Divers with a mild skin rash or other innocuous skin forms must see a physician. Left untreated, the skin rash develops easily into a Type ll decompression sickness.
Come and learn more about decompression illness in your Emergency First Response course. It is a great course to have as a diver or non-diver.
Dive safe everyone.