Neonatal-onset maculopapular cutaneous mastocytosis presenting with pigmented plaques in an infant
DOI:
https://doi.org/10.18203/2349-3291.ijcp20262977Keywords:
Maculopapular cutaneous mastocytosis, Urticaria pigmentosa, Pigmented plaquesAbstract
Cutaneous mastocytosis is a clonal disorder characterized by abnormal accumulation of mast cells in the skin. Maculopapular cutaneous mastocytosis (urticaria pigmentosa) is the most common form in children and usually presents within the first two years of life. Neonatal onset and blistering may complicate recognition and mimic other pigmentary dermatoses. We report a 10-month-old male with six well-defined brown plaques measuring 2–3 cm, two with central scars. A blister was noted at birth on the knee, followed by progressive lesion development. Physical examination revealed no lymphadenopathy or visceromegaly. Histopathology demonstrated dense dermal mast cell infiltration with metachromatic granules on Giemsa staining, confirming maculopapular cutaneous mastocytosis. The patient was treated with oral ketotifen with stable disease at six-month follow-up. Early recognition is essential to ensure appropriate counseling, monitoring, and avoidance of unnecessary investigations.
Metrics
References
Arber DA, Orazi A, Hasserjian RP, Borowitz MJ, Calvo KR, Kvasnicka HM, et al. International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data. Blood. 2022;140(11):1200-28. DOI: https://doi.org/10.1182/blood.2022015850
Valent P, Akin C, Metcalfe DD. Mastocytosis: 2016 updated WHO classification and novel emerging treatment concepts. Blood. 2017;129:1420-7. DOI: https://doi.org/10.1182/blood-2016-09-731893
Swarnkar B, Sarkar R. Childhood cutaneous mastocytosis: revisited. Indian J Dermatol. 2023;68(1):121. DOI: https://doi.org/10.4103/ijd.ijd_264_22
Ben-Amitai D, Metzker A, Cohen HA. Pediatric cutaneous mastocytosis: a review of 180 patients. Isr Med Assoc J. 2005;7(5):320-2.
Méni C, Bruneau J, Georgin-Lavialle S, Le Saché de Peufeilhoux L, Damaj G, Hadj-Rabia S, et al. Paediatric mastocytosis: a systematic review of 1747 cases. Br J Dermatol. 2015;172(3):642-51. DOI: https://doi.org/10.1111/bjd.13567
Fokoloros C, Xepapadaki P, Papadavid E, Katoulis A, Pappa V, Papageorgiou S, et al. Mastocytosis in the Skin: Disease Heterogeneity among Children and Adults. Acta Derm Venereol. 2023;103:adv00845. DOI: https://doi.org/10.2340/actadv.v103.4461
Brockow K, Bent RK, Schneider S, Spies S, Kranen K, Hindelang B, et al. Challenges in the diagnosis of cutaneous mastocytosis. Diagnostics (Basel). 2024;14(2):161. DOI: https://doi.org/10.3390/diagnostics14020161
Eichenfield LF, Honig PJ. Blistering disorders in childhood. Pediatr Clin N Am. 1991;38:959-76. DOI: https://doi.org/10.1016/S0031-3955(16)38162-7
Slapnicar CA, Smeenk CS, Hicks LK, Petrucci J, Vadas P, Trinkaus M. A retrospective case series describing the efficacy of ketotifen in systemic mastocytosis. Blood. 2018;132(Suppl 1):5474. DOI: https://doi.org/10.1182/blood-2018-99-120112
Heinze A, Kuemmet TJ, Chiu YE, Galbraith SS. Longitudinal Study of Pediatric Urticaria Pigmentosa. Pediatr Dermatol. 2017;34:144-9. DOI: https://doi.org/10.1111/pde.13066