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Tan Q, Zhang J. Visual Dermatology: Diffuse Cutaneous Mastocytosis With Bullous Lesions. J Cutan Med Surg 2021; 24:405. [PMID: 32722971 DOI: 10.1177/1203475420917380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Qi Tan
- 159456 Department of Dermatology, Children's Hospital of Chongqing Medical University, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Jian Zhang
- 159456 Department of Dermatology, Children's Hospital of Chongqing Medical University, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
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Affiliation(s)
- Divya Kamat
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Mashiah J, Harel A, Bodemer C, Hadj-Rabia S, Goldberg I, Sprecher E, Kutz A. Topical pimecrolimus for paediatric cutaneous mastocytosis. Clin Exp Dermatol 2018; 43:559-565. [PMID: 29460435 DOI: 10.1111/ced.13391] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Most cases of paediatric cutaneous mastocytosis (CM) occur before the age of 2 years, and regression occurs in only 67% of children. Given the absence of any specific therapy, CM is usually treated symptomatically. A few publications have reported the beneficial effect of calcineurin inhibitors for CM. AIM We sought to evaluate the clinical effectiveness and safety profile of topical pimecrolimus cream for the treatment of CM. METHODS We performed a retrospective study of all diagnosed cases of CM treated with topical pimecrolimus 1% cream between 2013 and 2015. All patients were evaluated in a paediatric dermatology unit of a tertiary medical centre. Epidemiological, clinical and treatment data, including effectiveness and safety, were reviewed. RESULTS In total, 18 children (11 male, 7 female; age range 3-42 months) with CM were evaluated. Of the 146 treated lesions, 39 (26.7%) disappeared and 98 (67%) faded or developed postinflammatory hyperpigmentation. Of the 119 papular lesions, 24 (16.4%) showed partial flattening and 56 (47%) became macular. Darier sign became negative in 14 (82%) of 17 patients. No topical or systemic complications were observed. CONCLUSIONS Topical therapy with pimecrolimus 1% cream should be considered in the treatment of CM.
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Affiliation(s)
- J Mashiah
- Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - A Harel
- Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - C Bodemer
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France.,INSERM 1163, Institut Imagine, Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - S Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France.,INSERM 1163, Institut Imagine, Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - I Goldberg
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Sprecher
- Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Kutz
- Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Zribi H, Zaouak A, El Euch D, Chelly I, Trojjet S, Zaraa I, Nidhameddine K, Mokni M, Osman AB. Erratum to "Bullous eruption in an infant, what's your diagnosis?" [Int J Pediatr Adolesc Med 1 (2) (2014) 104-106]. Int J Pediatr Adolesc Med 2015. [PMID: 30806380 DOI: 10.1016/j.ijpam.2014.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
[This corrects the article DOI: 10.1016/j.ijpam.2014.11.004.].
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Affiliation(s)
- Hela Zribi
- Dermatology Department, La Rabta Hospital, Tunis, Tunisia
| | - Anissa Zaouak
- Dermatology Department, La Rabta Hospital, Tunis, Tunisia
| | | | - Ines Chelly
- Department of Anatomopathology, La Rabta Hospital, Tunis, Tunisia
| | - Sondes Trojjet
- Dermatology Department, La Rabta Hospital, Tunis, Tunisia
| | - Ines Zaraa
- Dermatology Department, La Rabta Hospital, Tunis, Tunisia
| | | | - Mourad Mokni
- Dermatology Department, La Rabta Hospital, Tunis, Tunisia
| | - Amel Ben Osman
- Dermatology Department, La Rabta Hospital, Tunis, Tunisia
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Salas-Alanis JC, Rosales-Mendoza CE, Ocampo-Candiani J. Bullous mastocytosis mimicking congenital epidermolysis bullosa. Case Rep Dermatol 2014; 6:129-33. [PMID: 24926254 PMCID: PMC4035675 DOI: 10.1159/000362755] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
A 2-month-old female infant was referred to DebRA Mexico from the Regional Children's Hospital because of a generalized dermatosis from birth characterized by multiple blisters and erosions on the trunk, face and limbs, associated with minor trauma. A skin biopsy showing subepidermal blisters associated with a dermal infiltrate of Giemsa-positive cells and CD117-positive antibody was consistent with the diagnosis of bullous mastocytosis. Treatment with oral antihistamines, topical steroids, and antibiotics was initiated, leading to a remission of the lesions.
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Affiliation(s)
- Julio Cesar Salas-Alanis
- Basic Science Department, School of Medicine, Universidad de Monterrey, Monterrey, Mexico ; Dystrophic Epidermolysis Bullous Research Association Mexico (DebRA Mexico A.C.), Monterrey, Mexico ; Department of Dermatology, University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Cesar Eduard Rosales-Mendoza
- Dystrophic Epidermolysis Bullous Research Association Mexico (DebRA Mexico A.C.), Monterrey, Mexico ; Department of Biochemistry and Molecular Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Jorge Ocampo-Candiani
- Department of Dermatology, University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
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Gray C, Young L, Orchard D, Connell TG. Severe cutaneous mastocytosis in a 10-month-old infant. J Paediatr Child Health 2012; 48:1103. [PMID: 23217044 DOI: 10.1111/jpc.12000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Charmaine Gray
- Department of General Medicine; Infectious Diseases Unit; Royal Children's Hospital Melbourne; Parkville Victoria Australia
| | - Lauren Young
- Department of Dermatology; Royal Children's Hospital Melbourne; Parkville Victoria Australia
| | - David Orchard
- Department of Dermatology; Royal Children's Hospital Melbourne; Parkville Victoria Australia
| | - Tom G Connell
- Department of General Medicine; Infectious Diseases Unit; Royal Children's Hospital Melbourne; Parkville Victoria Australia
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Abstract
Mastocytosis is a rare disorder that shows accumulation of mast cells in tissues. Atypical clinical features may mimic impetigo, Langerhans cell histiocytosis, and carcinoid syndrome; however, only 1 case of scarring alopecia associated with mastocytosis has been reported. We present the first case of cutaneous mastocytosis associated with congenital alopecia areata in a 3-year-old Korean girl. This case showed an atypical clinical presentation of congenital alopecia areata, but histopathological results confirmed the diagnosis of cutaneous mastocytosis.
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Lange M, Niedoszytko M, Nedoszytko B, Łata J, Trzeciak M, Biernat W. Diffuse cutaneous mastocytosis: analysis of 10 cases and a brief review of the literature. J Eur Acad Dermatol Venereol 2011; 26:1565-71. [PMID: 22092511 DOI: 10.1111/j.1468-3083.2011.04350.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diffuse cutaneous mastocytosis (DCM) is an extremely rare disease characterized by mast cell (MCs) infiltration of the entire skin. Little is known about the natural course of DCM. OBJECTIVES We decided to characterize clinical manifestations, the frequency of MCs mediator-related symptoms and anaphylaxis, risk of systemic mastocytosis (SM) and prognosis, based on 10 cases of DCM, the largest series published to date. METHODS Diffuse cutaneous mastocytosis, DCM was confirmed by histopathological examination of skin samples in all cases. SCORing Mastocytosis (SCORMA) Index was used to assess the intensity of DCM. The analysis of clinical symptoms and laboratory tests, including serum tryptase levels was performed. Bone marrow biopsy was done only in selected cases. RESULTS Large haemorrhagic bullous variant of DCM (five cases) and infiltrative small vesicular variant (five cases) were identified. The skin symptoms appeared in age-dependent manner; blistering predominated in infancy, whereas grain-leather appearance of the skin and pseudoxanthomatous presentation developed with time. SM was not recognized in any of the patients. Mast cell mediator-related symptoms were present in all cases. Anaphylactic shock occurred in three patients. Follow-up performed in seven cases revealed slight improvement of skin symptoms, reflected by decrease of SCORMA Index in all of them. Serum tryptase levels declined with time in six cases. CONCLUSIONS Diffuse cutaneous mastocytosis, DCM is a heterogeneous, severe, cutaneous disease, associated with mediator-related symptoms and risk of anaphylactic shock. Although our results suggest generally favourable prognosis, the review of the literature indicate that SM may occur. Therefore, more guarded prognosis should be given in DCM patients.
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Affiliation(s)
- M Lange
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland.
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Kleewein K, Lang R, Diem A, Vogel T, Pohla-Gubo G, Bauer JW, Hintner H, Laimer M. Diffuse cutaneous mastocytosis masquerading as epidermolysis bullosa. Pediatr Dermatol 2011; 28:720-725. [PMID: 21854415 DOI: 10.1111/j.1525-1470.2011.01479.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 10-month-old boy presented with a history of a generalized cutaneous bullous eruption since 3 months of age. Emesis, flush, pruritus, and fatigue had accompanied relapsing episodes of sometimes extensive blistering. Histopathology showed dense dermal infiltrates of mast cells on hematoxylin and eosin and corroborating immunohistochemical staining. Laboratory examination revealed a markedly high level of serum tryptase. Based on these results and after consecutive staging, the patient was diagnosed with diffuse cutaneous bullous mastocytosis (BM). Mutation analysis detected a deletion mutation (del419) in C-Kit by direct exon sequencing. This rare entity must be considered in the differential diagnosis whenever a child presents with bullae and erosions. A crucial diagnostic hint is that rubbing of affected skin areas results in whealing (Darier's sign). A comprehensive diagnostic approach, advanced therapeutic strategies, regular follow-ups, and instruction of patients and relatives on prevention and prophylaxis are highly indicated.
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Affiliation(s)
- Kristin Kleewein
- Department of Dermatology, Paracelsus Medical University Salzburg, Austria
| | - Roland Lang
- Department of Dermatology, Paracelsus Medical University Salzburg, Austria
| | - Anja Diem
- Department of Dermatology, Paracelsus Medical University Salzburg, Austria
| | - Tobias Vogel
- Department of Dermatology, Nuremberg Hospital North, Nuermberg, Germany
| | | | - Johann W Bauer
- Department of Dermatology, Paracelsus Medical University Salzburg, Austria
| | - Helmut Hintner
- Department of Dermatology, Paracelsus Medical University Salzburg, Austria
| | - Martin Laimer
- Department of Dermatology, Paracelsus Medical University Salzburg, Austria
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