title: Diffuse Cutaneous Bullous Mastocytosis and Disseminated Intravascular Coagulation Postvaccination: A Case Report.
abstract: BACKGROUND
  Diffuse cutaneous bullous mastocytosis is the most rare subtype of cutaneous mastocytosis, characterized by generalized skin infiltration with mast cells and blistering.
  
  
  OBJECTIVE
  To increase the awareness of the natural history and potential adverse complications of this rare cutaneous condition.
  
  
  RESULTS
  We report a case of a male diagnosed on day 7 of life with follow-up of his progression over 6 years. When he was 2.5 months old, he was admitted to hospital postvaccinations with a flare of his blistering that was complicated by disseminated intravascular coagulation and polyuric acute tubular necrosis. Blistering ceased at 3 years, but at 6 years, extensive urtication continued in response to known triggers and a suboptimal dose of mast cell membrane stabilizers and histamine-1 and -2 receptor antagonists.
  
  
  CONCLUSIONS
  This case discusses the progression of this rare condition over 6 years and highlights the importance of reaching optimal pharmacologic blockage of histamine-1 and -2 receptors and stabilization of mast cell membranes in patients persistently experiencing ongoing pruritus, urtication, and flushing symptoms.
authors.affiliation: Dalhousie Medicine, Halifax, Nova Scotia, Canada alexandra.hudson@dal.ca.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hudson
authors.affiliation: Dalhousie Medicine, Halifax, Nova Scotia, Canada.|Division of Clinical Dermatology and Cutaneous Science, Halifax, Nova Scotia, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Finlayson
mesh_terms: D002648:Child; D002675:Child, Preschool; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007684:Kidney Tubules / Q000473:pathology*; D008297:Male; D034701:Mastocytosis, Cutaneous / Q000139:chemically induced / Q000150:complications* / Q000151:congenital*; D009336:Necrosis; D011141:Polyuria / Q000209:etiology; D000067251:Symptom Flare Up; D014581:Urticaria / Q000209:etiology; D014611:Vaccination / Q000009:adverse effects*
keywords: cutaneous mastocytosis; pediatric