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Histopathologic examination with Giemsa staining showed a dense infiltrate of mast cells (MCs) in the superficial dermis. These findings, in combination with his clinical presentation, confirmed the diagnosis of DCM. His serum tryptase level was less than 20 ng/L (reference range, 0.4-10.9 ng/L).
Cutaneous mastocytosis (CM) is defined as an increase of MCs in the skin, with 3 clinical phenotypes characteristic to the pediatric population: urticaria pigmentosa, solitary mastocytoma, and DCM. Many forms of CM are related to point mutations in the genes encoding growth factor receptor c-kit.1
Severe Pruritus in an 11-Month-Old Infant—Diagnosis. Arch Dermatol. 2010;146(5):557–558. doi:10.1001/archdermatol.2010.75-b