10.5826/dpc.1203a83
text/xml
2160-9381
1951
en
Elisa Camela
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
solitary mastocytoma, adult, cutaneous mastocytoma, mastocytosis, facial
A case of adult-onset facial cutaneous mastocytoma: clinical and dermoscopic findings
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2022-07-28
2021-08-12
2022-07-28
2022-09-21
e2022083
Dermatol Pract Concept
Elisa Camela
2022/07/28
10.5826/dpc.1203a83
e2022083
Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
2160-9381
solitary mastocytoma, adult, cutaneous mastocytoma, mastocytosis, facial
en
e2022083
A case of adult-onset facial cutaneous mastocytoma: clinical and dermoscopic findings
https://dpcj.org/index.php/dpc/article/download/1951/1658
                    Dermatology Practical & Conceptual


        A Case of Adult-onset Facial Cutaneous
    Mastocytoma: Clinical and Dermoscopic Findings
                 Matteo Megna1, Massimiliano Scalvenzi1, Sonia Sofía Ocampo Garza1,2,
                                Gabriella Fabbrocini1, Elisa Camela1


1 Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
2 Universidad Autónoma de Nuevo León, University Hospital ¨Dr. José Eleuterio González¨, Dermatology Department, Monterrey, Nuevo
  León, México



Key words: solitary mastocytoma, adult, cutaneous mastocytoma, mastocytosis, facial
Citation: Megna M, Scalvenzi M, Ocampo Garza SS, Fabbrocini G, Camela E. A case of adult-onset facial cutaneous mastocytoma: clinical
and dermoscopic findings. Dermatol Pract Concept. 2022;12(3):e2022083. DOI: https://doi.org/10.5826/dpc.1203a83
Accepted: October 17, 2021; Published: July 2022
Copyright: ©2022 Megna et al. This is an open-access article distributed under the terms of the Creative Commons Attribution
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: Elisa Camela, MD, Department of Dermatology, University of Naples Federico II, Via Pansini, 5 80131 Napoli,
Italy, Tel: +39 - 081 -7462457 Fax: +39 - 081 – 7462442, E-mail: elisacamela@gmail.com




Introduction                                                             Dermoscopic evaluation revealed an irregular vascular pat-
                                                                         tern characterized by irregular linear vessels, some of which
Cutaneous mastocytoma is a form of mastocytosis that usu-                serpiginous, of steady caliber, on a pink-red background
ally affects newborns and children, representing an uncom-               and perifollicular scar-like white areas (Figure 2). Incisional
mon finding in adults [1]. Clinically, it presents with up to            biopsy displayed the presence of a diffuse and homogeneous
3 yellowish, brown, or red nodular lesions mainly located                pan-dermal infiltrate of mast cells, with some perivascu-
on the trunk and extremities [1]. The most common dermo-                 lar and peri-adnexal lymphocytes and plasma cells in the
scopic feature is a yellow-orange blot pattern [1].                      upper dermis. To rule out systemic mastocytosis, routine
    We report the unusual case of an adult-onset facial cuta-            blood tests as well as serum tryptase (sT) were performed
neous mastocytoma, arising on the forehead, and describe a               resulting unremarkable. Based on clinical, dermoscopic and
new dermoscopic pattern.                                                 histologic findings along with normal sT levels and absence
                                                                         of systemic involvement, a diagnosis of cutaneous mastocy-
                                                                         toma was made. The patient was started on topical tacro-
Case presentation
                                                                         limus with progressive subsiding of clinical manifestations.
A 36-year-old woman came to our dermatology department
for the presence of an asymptomatic erythematous plaque on
                                                                         Conclusions
the forehead, of two-month-duration (Figure 1). The patient
was in good health and did not refer systemic symptoms;                       Adult-onset cutaneous mastocytoma is a rare entity de-
her medical and pharmacological history was unremarkable.                scribed in less than 20 patients so far [1]. Its diagnosis is



Research Letter | Dermatol Pract Concept. 2022;12(3):e2022083                                                                          1
Figure 1. Clinical aspect of facial cutaneous mastocytoma: an erythematous plaque of the forehead.




Figure 2. Dermoscopy of facial cutaneous mastocytoma: irregular vascular pattern with linear vessels, some of which serpiginous, showing
steady caliber; pink-red background; perifollicular scar-like white areas.



2                                                                          Research Letter | Dermatol Pract Concept. 2022;12(3):e2022083
challenging as it may be confused with a vast spectrum of             We reported the unusual case of adult-onset facial masto-
diseases according to its clinical presentation. Indeed, it may   cytoma, arising on the forehead, and described new dermo-
appear as a macule, papule, plaque or nodule and vary in          scopic findings. Although the strength of our observation is
color from yellow to brown, to red [2]. Dermoscopically,          limited by the single patient, we believe that enriching litera-
cutaneous mastocytoma has been reported to present a              ture with new information may contribute to improve diag-
yellow-orange blot pattern [2]. Anyway, in our case, an ir-       nosis of unusual manifestations.
regular vascular pattern exclusively characterized by irreg-
                                                                  Informed consent: Written informed consent was obtained
ular linear and serpiginous vessels of steady caliber, on a
                                                                  from the patient for publication of this case report and any
pink-red background and perifollicular scar-like white areas
                                                                  accompanying images.
were observed. More data are needed since reported der-
moscopic descriptions are very scant. Given that the onset
of cutaneous mastocytosis in adults is frequently associated      References
with systemic disease, it has been recommended that the ini-
                                                                   1. Vano-Galvan S, Álvarez-Twose I, De Las Heras E, et al. Dermo-
tial diagnostic work-up should include blood tests ( complete         scopic features of skin lesions in patients with mastocytosis. Arch
blood cell count, serum chemistries with liver function tests,        Dermatol. 2011;147(8):932-940. DOI:10.1001/archdermatol.
and sT levels), and also bone marrow biopsy (BMB) [2]. If             2011.190. PMID: 21844452.
there is no systemic involvement, all the above-mentioned in-      2. Cohen P. Solitary mastocytoma presenting in an adult: report and
                                                                      literature review of adult-onset solitary cutaneous mastocytoma
vestigations apart from BMB, should be repeated yearly [2].
                                                                      with recommendations for evaluation and treatment. Dermatol
In our case, due to the absence of systemic symptoms and
                                                                      Pract Concept. 2016;6(3):31-38. DOI:10.5826/dpc.0603a07.
normal sT, BMB was not performed. Concerning treatment,               PMID: 27648381. PMCID: PMC5006550.
surgical excision is the most employed one, followed by topi-
cal or intralesional corticosteroids [2]; other treatments com-
prise pimecrolimus and pulsed dye laser therapy [2].




Research Letter | Dermatol Pract Concept. 2022;12(3):e2022083                                                                          3
