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Question: Derm

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You are seeing a 14 month old who has a two irregularly oval yellow-tan lesions on his right upper arm, just under 1cm each. They have been present all his life and have grown slightly. Sometimes they seem to become acutely inflamed, and the boy has flushing and intense itching. 

Which of the following is NOT true of his condition?

pemsou5_wp • August 8, 2023

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  1. Kelly August 22, 2023 - 9:59 pm Reply

    B) Systemic symptoms such as nausea, vomiting, diarrhea, and abdominal pain are common
    The patient is presenting with cutaneous mastocytosis, specifically with two mastocytomas. 90% of pediatric mastocytosis is cutaneous, and 10% involves systemic symptoms. Of the cutaneous cases, the majority are urticaria pigmentosa, presenting as numerous polymorphic macules and papules. Mastocytomas are larger lesions that are usually present at birth and are solitary to a few (up to 3 total lesions by definition). Mastocytosis lesions may exhibit Darier’s sign – erythema and urticaria triggered by rubbing the lesion. Solitary mastocytomas often spontaneously resolve before puberty. Serum tryptase can be helpful in differentiating cutaneous mastocytosis from systemic disease.

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