10.5826/dpc.1304a200
text/xml
2160-9381
3140
en
Bianca Maria Piraccini
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
mastocytosis
Hemorrhagic Blister in an Infant
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2023-10-31
2023-01-09
2023-10-31
2024-01-15
e2023200
Dermatol Pract Concept
Bianca Maria Piraccini
2023/10/31
10.5826/dpc.1304a200
e2023200
Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
2160-9381
mastocytosis
en
e2023200
Hemorrhagic Blister in an Infant
https://dpcj.org/index.php/dpc/article/download/3140/2360
                           Hemorrhagic Blister in an Infant
            Iria Neri1, Luca Rapparini1,2, Francesco Paolo Salamone1,2, Miriam Leuzzi1,2,
                             Carlotta Gurioli1, Bianca Maria Piraccini1,2


1 Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
2 Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy



Citation: Neri I, Rapparini L, Salamone FP, Leuzzi M, Gurioli C, Piraccini BM. Hemorrhagic Blister In An Infant.
Dermatol Pract Concept. 2023;13(4):e2023200. DOI: https://doi.org/10.5826/dpc.1304a200
Accepted: February 14, 2023; Published: October 2023
Copyright: ©2023 Neri et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Luca Rapparini, Dermatology Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum,
University of Bologna, Bologna, Italy. Mail: luca.rapparini2@studio.unibo.it. ORCID 0000-0002-4029-941X




Case Presentation                                                        Teaching Point
An 8-month-old boy was referred to us for evaluation of a                     Mastocytoma is a variant of cutaneous mastocytosis can
large hemorrhagic tense blister with a pink rim involving                appear at birth or in the first months of life with indurated,
the dorsum of the right hand (Figure 1). He was otherwise                erythematous, yellow-brown macules, plaques or nodules
healthy and had a normal development (findings from his                  [1,2]. At the extremities and in sites subjected to friction or
physical examination were normal). The parents denied in-                pressure the lesions may blister as in our case. However, the
sect bite and frequent sucking of his right hand was reported.           hemorrhagic blister described in diffuse cutaneous mastocy-
The diagnosis of solitary mastocytoma with a hemorrhagic                 tosis are rarely observed in mastocytoma. We have assumed
blister was suspected. The blister was drained and healed in             that the site and repeated trauma for the habit of sucking the
seven days. At this time a sharply demarcated pink plaque                hand are the cause of hemorrhagic blister. This lesion in in-
with a leathery texture was evident. Darier’s sign was pos-              fancy may be mistaken for epidermolysis bullosa, arthropod
itive confirming the diagnosis of mastocytoma. Topical clo-              bite reaction or child abuse.
betasol propionate therapy has been set with benefit.




Image Letter | Dermatol Pract Concept. 2023;13(4):e2023200                                                                            1
                                                             References
                                                             1. Nemat K, Abraham S. Cutaneous mastocytosis in childhood.
                                                                 ­Allergol Sel. 2022;6(01):1–10. DOI: 10.5414/ALX02304E.
                                                                  PMID: 35028497. PMCID: PMC8750954.
                                                             2. Valent P, Akin C, Hartmann K, et al. Updated Diagnos-
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                                                                      Criteria and Classification of Mast Cell Disorders: A
                                                                ­Consensus Proposal. Hemasphere. 2021;5(11):e646. DOI:
                                                                  10.1097/HS9.0000000000000646. PMID: 34901755. PMCID:
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Figure 1. Solitary mastocytoma with a hemorrhagic blister.




2                                                                 Image Letter | Dermatol Pract Concept. 2023;13(4):e2023200
