Nickel's1 authoritative article on urticaria pigmentosa published in 1957 includes a brief description of bullous urticaria pigmentosa. T. C. Fox2 first reported the development of bullous lesions in urticaria pigmentosa in 1883. He described the presence of "distinct blisters, large watery scales or vessicated summits" and reported followup observations on 3 cases of urticaria pigmentosa previously documented by Tilbury Fox. Waters and Lacson3 reported a case of bullous urticaria pigmentosa in a boy, 5 years old, in which mast-cell leukemia presented itself as urticaria pigmentosa. Examination of this patient revealed a generalized eruption with erythema, vesicles, excoriations, crusting, and urticarial wheals. Kaminsky, Daitsch and Abulafia4 described the presence of a solitary lesion of urticaria pigmentosa in a 1-year-old boy. The lesion, located on the upper thigh, was the site of localized dermographism and of the development of spontaneous blisters on several occasions.
During the past 3