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J Korean Soc Emerg Med > Volume 34(4); 2023 > Article
Journal of The Korean Society of Emergency Medicine 2023;34(4): 370-378.
대리석양 피부 감압병은 경증 감압병인가, 중증 감압병인가?
정주원 , 이유진 , 권재화 , 강희동 , 오세현 , 정상구
울산대학교 의과대학 강릉아산병원 응급의학과
Should we consider cutis marmorata as mild or severe decompression sickness?
Joo Won Joung, , You Jin Lee , Jaehwa Kwon , Hui Dong Kang , Se Hyun Oh , Sang Ku Jung
Department of Emergency Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
Correspondence  Sang Ku Jung ,Tel: 033-610-5493, Fax: 033-610-4960, Email: jsangku@naver.com,
Received: August 30, 2022; Revised: September 21, 2022   Accepted: September 28, 2022.  Published online: August 31, 2023.
ABSTRACT
Objective:
The cutaneous manifestation of decompression sickness (DCS) known as cutis marmorata (CM) is generally mild, but it is often accompanied by severe DCS or may be a prognostic sign. We aimed to analyze the clinical course of patients with CM to improve our understanding of CM.
Method:
From January 2016 to December 2020, a retrospective cohort single-center study was conducted on patients with acute DCS who underwent emergency recompression therapy. We analyzed their data and the clinical outcomes after recompression therapy. In addition, we reviewed relevant literature.
Results:
A total of 341 people were enrolled during the study period. Of them 94 (27.6%) patients presented with CM and the symptoms appeared at an average of about 60.5 minutes after surfacing. Among the CM patients, 76.6% had accompanying DCS type II, and in 23.4%, had accompanying DCS type I (P=0.011). With single recompression therapy, 88.3% of patients with CM immediately recovered. Among these 95.4% of patients with DCS type I and 86.1% with DCS type II recovered immediately. However, there were no statistical differences in the immediate treatment outcomes according to the delay time from the onset of symptoms to recompression therapy, accompanying symptomatic DCS classification, and recompression modalities. Ultimately, all the patients recovered from CM.
Conclusion:
CM by itself can be considered a mild DCS in terms of treatment progress, but prompt treatment is required to prevent complications. In addition, greater focus is needed on other accompanying DCS symptoms in patients with CM, and the treatment method should be determined accordingly.
Key words: Decompression sickness; Diving; Skin; Treatment outcome
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