A 6-month old with total body flushing and a macular-papular lesion.
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.
Conrad
Heather
H
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA 90509, USA.
Gausche-Hill
Marianne
M
Burbulys
David
D
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
D006634:Histamine H1 Antagonists; D004155:Diphenhydramine