Variant Of Cutaneous Mastocytosis Research Articles

Telangiectasia Macularis Eruptiva Perstans Treated with Narrow-Band UVB Phototherapy and Heliotherapy during the COVID-19 Pandemic

Telangiectasia macularis eruptiva perstans (TMEP) is a rare disease, previously classified as a variant of cutaneous mastocytosis. While no gold standard of treatment exists, several treatments have been studied. We report a case of a 63-year-old woman who presented with long-standing asymptomatic telangiectatic macules beginning on the upper chest, back, and bilateral arms, with occasional pruritus and no other systemic symptoms. Skin biopsy, along with Giemsa stain, revealed findings consistent with TMEP. The patient underwent testing for serum tryptase level, which was within normal limits. The patient was started on topical steroids for two weeks and antihistamine therapy, with a noted decrease in pruritus but no change in cutaneous lesions. She was then advised to start phototherapy, and subsequently underwent a total of five sessions of narrow-band ultraviolet B phototherapy, after which she noted lightening of the lesions. Due to the COVID pandemic, the patient was shifted to heliotherapy with continued lightening of lesions after two months of thrice weekly sessions. This rare case is supportive of narrow-band ultraviolet B phototherapy and heliotherapy as promising treatment options for cases of TMEP.

Reflectance confocal microscopy as a diagnostic tool for mastocytoma in children

To the Editor: Mastocytoma is a variant of cutaneous mastocytosis, and its diagnosis is confirmed by histopathology. Because this condition primarily affects children, dermoscopy and reflectance confocal microscopy (RCM) are potentially useful complementary diagnostic tools because they are noninvasive. Using RCM (Vivascope 1500; Lucid Inc, Rochester, NY) and dermoscopy (CBS-908; CBS Inc, Wuhan, China), we retrospectively analyzed 8 cases of mastocytoma that had previously been diagnosed between 2014 and 2018.

Bullous mastocytosis in an infant treated with the help of narrowband ultraviolet B

Mastocytosis represents a group of disorders characterized by abnormal accumulation of mast cells in the bone marrow, liver, spleen, lymph nodes, gastrointestinal tract, and skin. Skin involvement is seen in almost all the cases. A 1-year-old male child presented with complaints of multiple fluid-filled lesions all over the body since 2 months. Examination revealed multiple vesicles and tense bullae present on the face, neck and trunk along with surrounding erythema and multiple excoriation marks. Darier's sign was positive. Histopathology showed dense infiltrates of mast cells in the papillary dermis. Bone marrow aspiration showed no mast cells infiltrate. The patient was started on oral antihistamines, prednisolone, and narrowband ultraviolet B (NBUVB). The skin lesions showed dramatic improvement within a week and patient is on follow-up with NBUVB. Bullous mastocytosis (BM) is a rare variant of cutaneous mastocytosis manifested by diffuse infiltration of skin by mast cells, where cutaneous bullae are the predominant feature. This case is being presented for its rarity and highlights the effectivity of NBUVB for treating BM.