By Gary M. White, MD
The solitary mastocytoma represents an aggregate of dermal mastocytes. It falls within the category of mastocytosis, along with TMEP, urticaria pigmentosa, systemic mastocytosis and bullous mastocytosis.
A solitary papulonodule present at birth or the first few weeks of life is most characteristic. It may have an orange peel surface and will urticate (Darier sign) or even blister upon stroking. Rarely, other mastocytomas may form. A general physical examination should be done and a CBC obtained.
These lesions usually resolve spontaneously in childhood. One study found the majority of cases resolving completely within 4–10 years [BJD 2016;174;411]. Surgical excision may be done. A high-potency topical steroid may decrease the size of the lesion. Some have suggested intralesional injection of triamcinolone. Avoidance of factors that trigger mast cell degranulation may be considered.
Solitary mastocytomas on the arms of infants.
Here is a mastocytoma urticating.
A 50-day-old baby girl presented with a skin colored raised lesion on the dorsal aspect of the left wrist since the age of 10 days, which gradually increased in size. On exam, it measured 2.5 cm in largest diameter. Indian J Dermatol 2014;59:634
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