Possible skin embolisms ?

[RSdiver]

I was recently on a dive trip to Wa katobi which is within 5 degrees of the equator and the water was quite warm to me so I didn't wear a wetsuit, just a lycra skin. The Swiss dive operator, Lorenz Maeder, came down hard on me saying I should wear a wetsuit as I am risking getting skin embolisms (no please, no thank you, just "you are wrong"). I responded that I'm quite warm diving that way, have been on numerous trips (over 800 dives) doing the same without incident and at home I typically dive in 50 degree water (with wetsuit).

He then stated that my lack of feeling cold was false,
that I am actually getting cold without knowing it and risking getting skin embolisms. I thanked him for his concern and on the next 5 dives made a point of touching my skin, inspecting the temperature and noticed that it wasn't cold at all.

Is a skin embolism real or was this operator being retentive (like in several other incidents)?

How can you detect skin embolisms?

 

[rmediver2002]

The skins circulation is entirely capillary, if it were warm (flushed) at the begining of a dive and you got really chilled during the dive then it could potentialy increase the chance of type I dcs (cutis marmerata) marbling of the skin.

This is quite a stretch though, I have only seen a few cases of marbeling and they all presented with other more serious type II symptoms...

I would be more concerned with some type of reaction to marine life (jellies, hydroids, coral, etc.) than with skin DCS.

I also dive warm water in just a bathing suit and never have any trouble, I think the guide was misinformed...

Hope you had some great dives!!!

Jeff Lane

 

[Dr Deco]

Dear Readers:

Skin Embolism?

I do not really know to what this refers since it is not a word in the barophysiology lexicon. I suspect he was referring to what “rmediver” mentioned above, viz, “cutis marmorata” or marbling of the skin.

This condition does not have a clear etiology (cause) but has been ascribed to arterial gas embolism of the skin capillaries. Peter Wilmshurst in England finds a large proportion of the divers he has seen with this skin condition following diving also have a patent foramen ovale (small hole between the atria of the heart). This would imply, that decompression gas bubbles can pass from the venous circulation to the arterial circulation and then embolize the skin. It is known that marbling also is an accompanying sign when neurological DCS is present.

This cannot be brought on, however, by diving in warm water. Diving yes, but that warm water contributes, I would have to stretch a bit on that one.

Dr Deco :doctor:

Readers, please note the next class in Decompression Physiology :grad:
http://wrigley.usc.edu/hyperbaric/advdeco.htm