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VOLUME 28 , ISSUE 1 ( January, 2024 ) > List of Articles


Skin Mottling in Dark-skinned Indian Patients with Severe Septic Shock: A Window to the Circulation or a Closed Door?

Jigeeshu Vasishtha Divatia

Keywords : Dark-skin color, Mortality, Peripheral tissue perfusion, Septic shock, Skin mottling

Citation Information : Divatia JV. Skin Mottling in Dark-skinned Indian Patients with Severe Septic Shock: A Window to the Circulation or a Closed Door?. Indian J Crit Care Med 2024; 28 (1):18-19.

DOI: 10.5005/jp-journals-10071-24633

License: CC BY-NC 4.0

Published Online: 30-12-2023

Copyright Statement:  Copyright © 2024; The Author(s).


Skin mottling has been found to be useful as a marker of peripheral hypoperfusion in shock in studies performed on fair-skinned patients. Whether skin mottling may be less apparent in dark-skinned patients, thus limiting its value in this patient population has not been studied. Jog et al. have performed an elegant study addressing this question, which is important and especially relevant to the Indian situation. They found that mottling is not easily visible in dark-skinned Indian patients, and when it becomes apparent, it is associated with a very high mortality. This study also throws up some areas for future research, including interobserver variability in the detection of mottling, and the hemodynamic and microcirculatory parameters associated with the appearance of mottling. Based on this study, the utility of skin mottling as a tool to guide hemodynamic management in severe septic shock in dark-skinned Indian patients is questionable.

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