A rare presentation of solitary mastocytoma in the palm of an infant

Childhood Solitary Cutaneous Mastocytoma: Clinical Manifestations, Diagnosis, Evaluation, and Management

BACKGROUND

The diagnosis of solitary cutaneous mastocytoma is mainly clinical, based on lesion morphology, the presence of a positive Darier sign, and the absence of systemic involvement. Knowledge of this condition is important so that an accurate diagnosis can be made.

OBJECTIVE

To familiarize physicians with the clinical manifestations, diagnosis, evaluation, and management of a solitary cutaneous mastocytoma.

METHODS

A PubMed search was completed in Clinical Queries using the key term "solitary cutaneous mastocytoma". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Only papers published in English language were included. The information retrieved from the above search was used in the compilation of the present article.

RESULTS

Typically, a solitary cutaneous mastocytoma presents as an indurated, erythematous, yellow- brown or reddish-brown macule, papule, plaque or nodule, usually measuring up to 5 cm in diameter. The lesion often has a peau d'orange appearance and a leathery or rubbery consistency. A solitary cutaneous mastocytoma may urticate spontaneously or when stroked or rubbed (Darier sign). Organomegaly and lymphadenopathy are characteristically absent. The majority of patients with skin lesions that erupt within the first two years of life have spontaneous resolution of the lesions before puberty. Treatment is mainly symptomatic. Reassurance and avoidance of triggering factors suffice in most cases.

CONCLUSION

The diagnosis is mainly clinical, based on the morphology of the lesion, the presence of a positive Darier sign, and the absence of systemic involvement. A skin biopsy is usually not necessary unless the diagnosis is in doubt.

Solitary mastocytoma of the vulva

Solitary mastocytoma of the skin is a rare tumor. Its occurrence in the vulva is extremely rare with only few case reports in the literature. We report a solitary mastocytoma of the vulva in a 10-year-old girl. Her systemic examination was unremarkable. The clinical and histopathological features were consistent with the diagnosis of solitary mastocytoma of the vulva. The follow-up after surgical excision was uneventful. The purpose of this communication is (i) to report a case of solitary mastocytoma occurring in an unusual site, the vulva and to show that (ii) in this case age at presentation is 10 years with infancy as common age of presentation of solitary mastocytoma, and to show that (iii) in appropriate setting this should be included in the differential diagnosis of vulval swelling.