Which skin lesion characteristics indicate mastocytosis?

Updated: Sep 16, 2020
  • Author: Jacquiline Habashy, DO, MSc; Chief Editor: Dirk M Elston, MD  more...
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Skin lesion color, quantity, and size findings are as follows:

  • Yellow-tan to red-brown

  • From 1 to more than 1000

  • From 1 mm to several centimeters

Skin special characteristics are as follows:

  • Darier sign: Wheal and surrounding erythema develop in a lesion after rubbing it.

  • Dermatographism: In approximately half the patients, stroking macroscopically uninvolved skin produces dermographia.

  • Flushing: Flushing may occur spontaneously following skin stroke or after ingesting a mast cell degranulating agent.

  • Diffuse cutaneous mastocytosis (DCM): This is rare and is characterized by mast cell infiltration of the entire skin.

  • Other: Large hemorrhagic bullous and infiltrative small vesicular variants occur. Blistering predominates in infancy, whereas grain-leather appearance of the skin and pseudoxanthomatous presentation develop with time. Anaphylactic shock may occur.

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