Skin

Skin bends or DI of the skin may present in a variety of ways with varying etiologies and clinical significance.

Diver's Lice

This erythematous rash usually presents in association with dry chamber dives or the use of dry suits. The hypothesis is that inert gas enters the skin directly and causes dermal bubbles with histamine release upon decompression. The condition can be avoided by not having gas skin contact, or by heating the skin during decompression. It is not considered serious in the absence of other findings, and does not require recompression.

Cutis Marmorata

A more significant form of DI of the skin is called cutis marmorata or skin marbling. Although the condition itself is benign, its association with pulmonary and neurological DI requires careful consideration. Experimental work in pigs has shown that this pattern of illness is associated with venous congestion, inflammation, leukocyte adherence and endothelial damage 98. No bubbles have been visualized, but the manifestations usually resolve promptly with recompression.

Counterdiffusion

A rare type of DI may result from exposure to different inert gases, such as helium and nitrogen. Diffusion-related gas accumulation may occur when one gas is in contact with the skin, while another is breathed 99,100.

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