title: A 6-month old with total body flushing and a macular-papular lesion.
abstract: Flushing of the skin of an infant may be a sign of the child's first allergic reaction to food, insect envenomation, or other allergens, a sign of sepsis, or due to dilation of cutaneous vessels caused by a vasodilator substance or neural mechanisms. A rare cause of this condition results in the release of mast cell mediators such as histamine, prostaglandin D2, tryptase, chymase, and leukotrienes. We present a case of a 6-month-old with severe total body flushing and a yellow-tan, raised, well-demarcated lesion on the thigh consistent with a solitary mastocytoma. Erythema was most pronounced adjacent to the lesion, suggesting a positive Darier sign. Subsequent evaluation by a dermatologist confirmed the diagnosis, and the patient underwent no further therapy; however, the family was appropriately counseled on management if the symptoms were to reappear. Appropriate diagnosis and management of this patient and other forms of mastocytosis in children are discussed.
authors.affiliation: Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA 90509, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Conrad
authors.forename: Marianne
authors.initials: M
authors.lastname: Gausche-Hill
authors.forename: David
authors.initials: D
authors.lastname: Burbulys
mesh_terms: D003937:Diagnosis, Differential; D004155:Diphenhydramine / Q000627:therapeutic use; D005483:Flushing / Q000188:drug therapy / Q000209:etiology*; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006636:Histamine Release; D006801:Humans; D007223:Infant; D008297:Male; D034801:Mastocytoma / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D009508:Nevus, Pigmented / Q000175:diagnosis; D010808:Physical Examination; D010812:Physical Stimulation; D013848:Thigh; D014972:Xanthogranuloma, Juvenile / Q000175:diagnosis; D014973:Xanthomatosis / Q000175:diagnosis
chemical_list: D006634:Histamine H1 Antagonists; D004155:Diphenhydramine