A solitary mastocytoma on the side of the foot of a young child.

SOLITARY MASTOCYTOMA

The solitary mastocytoma (SM) represents an aggregate of dermal mastocytes. It falls within the category of mastocytosis, along with TMEP, urticaria pigmentosa, systemic mastocytosis and bullous mastocytosis.

Onset is usually within the first 6 months of life.

Clinical

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.

Workup

A general physical examination should be done and a CBC obtained.

Treatment

These lesions usually resolve spontaneously in childhood. One study found the majority of cases resolving completely within 4–10 years. 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. If the patient flushes, the parents may want to have an antihistamine at home and take with them when out.

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