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1.
J Cutan Pathol ; 51(11): 876-880, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39081060

RESUMEN

BACKGROUND: Histopathologic criteria for diagnosis of cutaneous mastocytosis include 20 mast cells per high-power field or clusters of 15 mast cells. We aimed to determine the specificity of these criteria for cutaneous mastocytosis in comparison with inflammatory disorders of mast cell activation. METHODS: Twenty-six cases of spongiotic dermatitis or urticaria were identified from 2021 to 2022. Recuts were stained with mast cell tryptase and slides were reviewed for the presence of 20 mast cells per high-power field and for clusters of 15 mast cells. In addition, seven cases of mastocytosis were reviewed for the same criteria. RESULTS: Twelve of 26 cases (46.1%) of spongiotic dermatitis/urticaria had at least 20 mast cells per high-power field. Three of 26 cases (11.5%) of spongiotic dermatitis/urticaria had a cluster of 15 mast cells. Six of seven cases (85.7%) of mastocytosis had at least 20 mast cells per high-power field; four of seven cases (57.1%) of mastocytosis had a cluster of 15 mast cells. CONCLUSIONS: In our study, the finding of 20 mast cells per high-power field was nonspecific as a single criterion for cutaneous mastocytosis. The finding of clusters of 15 mast cells was more specific but not sensitive.


Asunto(s)
Mastocitos , Mastocitosis Cutánea , Piel , Humanos , Mastocitos/patología , Mastocitos/metabolismo , Mastocitosis Cutánea/patología , Mastocitosis Cutánea/diagnóstico , Masculino , Femenino , Adulto , Persona de Mediana Edad , Biopsia , Piel/patología , Anciano , Adolescente , Dermatitis/patología , Dermatitis/diagnóstico , Niño , Adulto Joven , Urticaria/patología , Urticaria/diagnóstico , Triptasas/metabolismo , Estudios Retrospectivos
2.
J Cutan Pathol ; 51(11): 881-892, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39092659

RESUMEN

BACKGROUND: The subcellular distribution of CD30 on mast cells and the presence of eosinophils in cutaneous mastocytosis require further investigation, especially as the cell surface expression of CD30 is critical for the therapeutic response of systemic mastocytosis to brentuximab vedotin. OBJECTIVE: Investigation of 147 biopsy specimens from 143 patients with cutaneous mastocytosis for mast cell density and distribution, frequency of CD30 expression, CD30 staining patterns, and presence and distribution of eosinophils. Correlation with clinical patterns. METHODS: Retrospective multicenter immunohistochemical study of CD30 expression, eosinophils and basic clinical data in cutaneous mastocytosis. RESULTS: CD30 expression was found in all samples (cut-off: ≥1%), whereby the staining was predominantly cytoplasmic in 99% of the samples. Additional membrane staining was detected in 62% of the samples. Surface expression of CD30 was more common in biopsy specimens with a high mast cell burden and in biopsy specimens with a higher CD30 expression rate. Eosinophils were admixed in 58% of the samples. Females and older patients showed a trend of a lower mast cell burden. LIMITATIONS: Retrospective study on formalin-fixed and paraffin-embedded tissue without functional analysis. CONCLUSION: Most cases of cutaneous mastocytosis show cell surface expression of CD30 expression and is, therefore, in principle, accessible for therapy with antibodies against CD30, provided the overall situation of the patient warrants.


Asunto(s)
Eosinófilos , Antígeno Ki-1 , Mastocitos , Mastocitosis Cutánea , Humanos , Antígeno Ki-1/metabolismo , Antígeno Ki-1/biosíntesis , Femenino , Masculino , Estudios Retrospectivos , Persona de Mediana Edad , Mastocitosis Cutánea/patología , Mastocitosis Cutánea/metabolismo , Adulto , Anciano , Mastocitos/metabolismo , Mastocitos/patología , Eosinófilos/metabolismo , Eosinófilos/patología , Anciano de 80 o más Años , Adolescente , Niño , Preescolar , Adulto Joven , Biopsia , Inmunohistoquímica/métodos
3.
Pediatr Dermatol ; 41(2): 256-259, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38145963

RESUMEN

There has been limited research exploring how the demographic characteristics of children with pediatric cutaneous mastocytosis (PCM) may influence both the cutaneous and systemic symptoms. In this observational retrospective study of 51 children with PCM, we found a significantly higher rate of gastrointestinal (GI) symptoms in children of Hispanic ethnicity (4/21,19%) compared to non-Hispanics (0/30, 0%, p = 0.024). While this finding may reflect the high proportion of Hispanics in our population, a racial predisposition toward distinct systemic symptoms may be possible. We also found a significantly lower proportion of Hispanic children being diagnosed with PCM under the age of 3 years (47.6%) when compared with non-Hispanic children (76.7%, p = 0.03), suggesting that more data are needed to further assess the role of ethnicity and healthcare disparities in PCM diagnosis. Larger prospective studies are necessary to better evaluate the association between ethnicity, early diagnosis, and systemic symptoms in PCM and to describe its impact on long-term outcomes.


Asunto(s)
Etnicidad , Mastocitosis Cutánea , Humanos , Niño , Preescolar , Estudios Retrospectivos , Estudios Prospectivos , Hispánicos o Latinos , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/epidemiología
4.
Pediatr Dermatol ; 41(3): 504-507, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38156740

RESUMEN

Idiopathic eruptive macular pigmentation (IEMP) is a rare, benign, self-resolving melanosis consisting of hyperpigmented macules typically on the face, trunk, and extremities that can occur in children and adolescents and often presents a diagnostic conundrum. We report a case involving an 8-year-old female whose previous clinical presentation was concerning for an atypical presentation of cutaneous mastocytosis or neurofibromatosis. The clinical and histopathologic evaluation was consistent with the diagnosis of IEMP, and no active intervention was pursued. Our accompanying literature review serves to better characterize this condition, highlight key diagnostic features, and emphasize the tendency for spontaneous resolution to avoid unnecessary treatments with limited clinical efficacy.


Asunto(s)
Hiperpigmentación , Humanos , Femenino , Niño , Hiperpigmentación/diagnóstico , Hiperpigmentación/patología , Diagnóstico Diferencial , Melanosis/diagnóstico , Melanosis/patología , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/patología
5.
Pediatr Dermatol ; 41(3): 458-460, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38305078

RESUMEN

Mast cells (MCs) can release a variety of biologically active mediators under different circumstances, such as fever or vaccination. Our aim was to evaluate the incidence and severity of MC activation symptoms induced by SARS-CoV-2 virus (COVID-19) infection and vaccination in a cohort of 92 pediatric patients with cutaneous mastocytosis. Our findings support previous evidence on the safety of COVID-19 infection and vaccination in patients with MC disorders.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Mastocitosis Cutánea , SARS-CoV-2 , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Estudios Transversales , Estudios Retrospectivos , Vacunación
6.
Int J Mol Sci ; 25(3)2024 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-38338679

RESUMEN

Mastocytosis is a heterogeneous disease characterized by the expansion and accumulation of neoplastic mast cells in various tissues. Diffuse cutaneous mastocytosis (DCM) is a rare and most severe form of cutaneous mastocytosis, which typically occurs in childhood. There have been reports of a familial DCM with specific gene mutations, indicating both sporadic and hereditary factors involved in its pathogenesis. DCM is associated with severe MC mediator-related symptoms and an increased risk of anaphylaxis. The diagnosis is based on the appearance of skin lesions, which typically show generalized thickening, erythroderma, blistering dermographism, and a positive Darier's sign. Recognition, particularly in infants, is challenging due to DCMs resemblance to other bullous skin disorders. Therefore, in unclear cases, a skin biopsy is crucial. Treatment focuses on symptom management, mainly including antihistamines and mast cell stabilizers. In extremely severe cases, systemic steroids, tyrosine kinase inhibitors, phototherapy, or omalizumab may be considered. Patients should be equipped with an adrenaline autoinjector. Herein, we conducted a comprehensive review of literature data on DCM since 1962, which could help to better understand both the management and prognosis of DCM, which depends on the severity of skin lesions, intensity of mediator-related symptoms, presence of anaphylaxis, and treatment response.


Asunto(s)
Anafilaxia , Lupus Eritematoso Cutáneo , Mastocitosis Cutánea , Mastocitosis , Lactante , Humanos , Anafilaxia/etiología , Anafilaxia/patología , Enfermedades Raras/patología , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/terapia , Mastocitosis/diagnóstico , Mastocitosis/terapia , Mastocitosis/patología , Piel/patología , Lupus Eritematoso Cutáneo/patología , Mastocitos/patología
7.
Acta Vet Hung ; 71(3-4): 183-192, 2024 01 09.
Artículo en Inglés | MEDLINE | ID: mdl-38112689

RESUMEN

Canine cutaneous mast cell tumours (CCMCTs) are common in dogs and exhibit many unpredictable behaviors. This study aimed to encourage pathology laboratories in developing countries to routinely assess prognosis by applying commonly used histopathological grading systems and immunohistochemistry (IHC) markers. We performed histological grading according to both the Patnaik and Kiupel systems, determined the mitotic count (MC) and carried out IHC for the detection of Ki67, Bax, Bcl-2 and KIT in 54 CCMCT cases. MC was associated with both grading systems in terms of survival following diagnosis and prognostic factors differed among cases categorized by the cut-off value of 5. KIT patterns were associated with grading systems and MC. The cohort with pattern II had a lower survival rate than those with patterns I and III. Ki67 was associated with survival when evaluated over the cut-off value of 0.018. Bax expression was associated with both grading systems. Median survival time was longer in patients with lower Bax expression level. Immunohistochemical detection of KIT, Ki67 and Bax improves histopathology in predicting the prognosis. If IHC is unavailable, reports regarding MC and values from both grading systems are the most effective, convenient and cost-effective way to provide the most reliable prognostic data and guidance for the clinicians.


Asunto(s)
Enfermedades de los Perros , Mastocitosis Cutánea , Neoplasias Cutáneas , Humanos , Perros , Animales , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/veterinaria , Mastocitosis Cutánea/patología , Mastocitos/metabolismo , Mastocitos/patología , Antígeno Ki-67/metabolismo , Proteína X Asociada a bcl-2/metabolismo , Pronóstico , Enfermedades de los Perros/metabolismo , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/veterinaria
8.
Arerugi ; 73(2): 189-195, 2024.
Artículo en Japonés | MEDLINE | ID: mdl-38522933

RESUMEN

A 2-year-old, male patient presented with an 18-month history of scattered, brown macules and nodules up to 2 cm in size on his trunk and extremities. These macules were accompanied by pruritus and were positive for Darier's sign. A skin biopsy of a brown macule on the left thigh revealed a dense accumulation of CD117-positive, round or oval cells with amphophilic cytoplasm within the upper to middle dermis. The patient was otherwise healthy and had normal laboratory and imaging test results. Sequence analysis of genomic DNA from a skin biopsy demonstrated the presence of an Asp419del mutation in exon 8 of the KIT gene. Based on these findings, maculopapular cutaneous mastocytosis (MPCM) was diagnosed. The patient received H 1-antihistamine. Although the pruritus resolved, the brown macules remained for one year after the initial treatment. To the best of our knowledge, only three cases of cutaneous mastocytosis (CM) with an Asp419del mutation, including the present case, have been reported in the Japanese literature to date; moreover, while the previous two cases were of DCM, the present case was the first instance of MPCM. Normally, the symptoms of childhood-onset MPCM are dormant until puberty. However, a recent study reported that many MPCM patients may experience persistent or exacerbated symptoms. The present study therefore evaluated 53 Japanese cases of childhood onset MPCM with a KIT gene mutation and discussed the patients' clinical outcomes.


Asunto(s)
Mastocitosis Cutánea , Urticaria Pigmentosa , Humanos , Masculino , Preescolar , Urticaria Pigmentosa/diagnóstico , Urticaria Pigmentosa/genética , Urticaria Pigmentosa/patología , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/genética , Mastocitosis Cutánea/patología , Piel/patología , Mutación , Prurito
9.
Int Arch Allergy Immunol ; 184(8): 776-782, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37071972

RESUMEN

INTRODUCTION: The management of the COVID-19 vaccine in children with mastocytosis is unclear due to a lack of data. In the current study, we aimed to evaluate the adverse reactions following COVID-19 vaccination in adolescents with cutaneous mastocytosis (CM). METHODS: This study included 27 paediatric patients who were diagnosed with CM and were followed up in the paediatric allergy department of a tertiary care children's hospital. RESULTS: The median (IQR) age of the patients at the time of COVID-19 vaccination was 180 (156-203) months. Forty-four per cent of patients were vaccinated with the COVID-19 vaccine. Among all participants, the vaccination rate was found to be higher in older children, those who had been diagnosed with MPCM, and those who had not been infected with COVID-19 (p = 0.019, p = 0.009, p = 0.002, respectively). A total of 23 doses of the COVID-19 vaccine, including two doses of Sinovac/CoronaVac and 21 doses of Pfizer/BioNTech, were administered to 12 paediatric patients with CM. One of the patients had a history of intense itch, erythematous urticarial plaques, and had an exacerbation of existing skin lesions within 24-48 h after both doses of Pfizer/BioNTech vaccination. CONCLUSION: The COVID-19 vaccination of patients with CM in this series seems to be safe, and the rate of adverse events was comparable to that in the general population. These results found in adolescents with CM are in line with the existing evidence that CM does not preclude vaccination in children.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Mastocitosis Cutánea , Urticaria , Vacunas , Adolescente , Niño , Humanos , Lactante , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Vacunación/efectos adversos
10.
Vet Pathol ; 60(6): 849-856, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37222130

RESUMEN

Cutaneous mastocytosis (CM) is a rare condition in young dogs characterized by multicentric cutaneous proliferation of neoplastic mast cells. Clinical data from 8 dogs that met inclusion criteria (age of onset less than 1.5 years, greater than 3 lesions) were obtained via a standardized survey. Biopsy samples were classified by the Kiupel/Patnaik grading systems and analyzed for c-KIT mutations. The median age of onset was 6 months (range: 2-17 months). Dogs had 5 to more than 50 lesions characterized as nodules, plaques, and papules. Seven dogs were pruritic. Clinical staging in 2 dogs did not reveal visceral involvement. No dogs had systemic illnesses at diagnosis. Histologically, CM was similar to cutaneous mast cell tumor (cMCT). Two dogs had neoplasms classified as high-grade/grade II while 6 dogs had low-grade/grade II neoplasms. No dogs had mutations in c-KIT exons 8 and 11. Treatment included antihistamines (8/8), corticosteroids (7/8), lokivetmab (3/8), and toceranib (1/8). Six dogs were alive with lesions at the end of the study with a median follow-up time of 898 days, while 2 dogs were euthanized. In dogs with high-grade/grade II neoplasms, one continued to develop lesions at 1922 days post-diagnosis, while the other dog was euthanized at 56 days post-diagnosis. One dog was euthanized 621 days post-diagnosis due to rupture of a neoplasm. CM occurs in young dogs and is histologically indistinguishable from cMCT. Current histologic grading systems did not apply uniformly to the dogs of the study and further studies are needed.


Asunto(s)
Enfermedades de los Perros , Mastocitosis Cutánea , Neoplasias Cutáneas , Perros , Animales , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/veterinaria , Mastocitosis Cutánea/patología , Piel/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/veterinaria , Neoplasias Cutáneas/patología , CME-Carbodiimida , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/patología , Mastocitos/patología
11.
Am J Dermatopathol ; 45(5): 339-342, 2023 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-36939143

RESUMEN

ABSTRACT: Mast cell skin disease is rarely described after external beam radiation therapy in patients with breast carcinoma, with only 7 previous reports in the literature. Skin changes typically occur within (but are not limited to) the radiation field. We present a 64-year-old woman with postradiotherapy cutaneous mastocytosis on the left breast and adjacent chest wall. The clinical and laboratory findings in all reported patients, including the current case, are reviewed. No clear mechanism has been presented to explain disease pathogenesis; although, mast cell accumulation secondary to local mediators produced in response to radiation damage and/or koebnerization phenomenon have been proposed. Cutaneous/systemic mastocytosis is not widely recognized and may be underdiagnosed in the setting of postradiation for breast cancer. It is important for clinicians and pathologists to be aware of this diagnosis for patients presenting with rashes after radiotherapy.


Asunto(s)
Neoplasias de la Mama , Mastocitosis Cutánea , Mastocitosis Sistémica , Mastocitosis , Femenino , Humanos , Persona de Mediana Edad , Mastocitosis/diagnóstico , Mastocitosis/patología , Mastocitosis Cutánea/etiología , Mastocitosis Cutánea/patología , Mastocitos/patología , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/patología
12.
Am J Dermatopathol ; 45(10): 697-703, 2023 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-37378479

RESUMEN

ABSTRACT: Mastocytosis is a condition characterized by accumulation of clonal mast cells (MCs) that often involves the skin. Pathologists are often challenged with skin biopsies with a question of cutaneous lesions of mastocytosis (CLM) including cutaneous mastocytosis, mastocytosis in the skin, or systemic mastocytosis. The histopathological criteria for CLM remain poorly defined due to heterogeneity of the published literature and the lack of comparative prospective studies. MC count is greatly influenced by detection and counting techniques, criteria for viable MCs used, anatomical location biopsied, and the dermal level that is analyzed. Although MC numbers in CLM can be significantly higher compared with healthy controls and a patient with other inflammatory skin diseases, in some instances, considerable overlap exists. Based on the largest studies published, it is suggested that a number of MCs between 75 and 250 MCs/mm 2 are a range in which CLM should be considered and, above 250 MC/mm 2 , a diagnosis of CLM can be made. A recent study showed a high specificity of >95% of a MC count >139 MC/mm 2 compared with patients with other inflammatory skin diseases. Noteworthy, the total number and percentage of MCs is significantly higher in children compared with adults, particularly in polymorphic maculopapular cutaneous mastocytosis. In difficult cases, ancillary techniques such as D816V mutation analysis on formalin-fixed paraffin-embedded tissue have a high sensitivity and specificity. There is no enough evidence that immunohistochemistry of CD25, CD2, or CD30 has any additional value in the diagnosis, subtyping, or clinical course of mastocytosis.


Asunto(s)
Dermatitis , Mastocitosis Cutánea , Mastocitosis , Adulto , Niño , Humanos , Estudios Prospectivos , Mastocitosis/diagnóstico , Mastocitosis/patología , Mastocitos/patología , Mastocitosis Cutánea/patología , Fenotipo , Dermatitis/patología , Recuento de Células , Proteínas Proto-Oncogénicas c-kit/análisis
13.
Dermatol Online J ; 29(6)2023 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-38478675

RESUMEN

Diffuse cutaneous mastocytosis with bullous formation is a rare childhood disease. We report a 5-month-old male who presented with a 3-week history of cutaneous bullae and pruritus. On examination, he had erythema of the cheeks bilaterally and diffuse slightly hyperpigmented, indurated skin on his trunk and abdomen. There were tense vesicles, bullae, and erosions linearly arranged on his trunk and extremities. Both the laboratory and imaging workup were normal. Subsequently, a punch biopsy of a vesicle on the abdomen was obtained and findings confirmed a diagnosis of diffuse cutaneous mastocytosis. An EpiPen(r) was prescribed due to the slightly increased anaphylaxis risk compared to other forms of mastocytosis. There are many purported triggers of diffuse cutaneous mastocytosis and there is currently no known cure which makes management of this disease challenging. This case highlights a rare condition for which official treatment guidelines do not exist. A prompt dermatologic diagnosis is necessary to ensure proper workup and regulation is in place.


Asunto(s)
Vesícula , Mastocitosis Cutánea , Humanos , Masculino , Niño , Lactante , Mastocitosis Cutánea/complicaciones , Mastocitosis Cutánea/diagnóstico , Piel/patología , Prurito , Eritema
14.
Exp Dermatol ; 31(11): 1729-1740, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-35876458

RESUMEN

Mastocytosis is a KIT-related myeloproliferative disease characterised by abnormal expansion of neoplastic mast cells (MC) in the skin or virtually any other organ system. The cutaneous form of adult-onset mastocytosis is almost invariably combined with indolent systemic involvement for which curative therapy is yet not available. Here we evaluated a concept of depleting cutaneous MCs in mastocytosis lesions ex vivo by targeting their secretory granules. Skin biopsies from mastocytosis patients were incubated with or without mefloquine, an antimalarial drug known to penetrate into acidic organelles such as MC secretory granules. Mefloquine reduced the number of dermal MCs without affecting keratinocyte proliferation or epidermal gross morphology at drug concentrations up to 40 µM. Flow cytometric analysis of purified dermal MCs showed that mefloquine-induced cell death was mainly due to apoptosis and accompanied by caspase-3 activation. However, caspase inhibition provided only partial protection against mefloquine-induced cell death, indicating predominantly caspase-independent apoptosis. Further assessments revealed that mefloquine caused an elevation of granule pH and a corresponding decrease in cytosolic pH, suggesting drug-induced granule permeabilisation. Extensive damage to the MC secretory granules was confirmed by transmission electron microscopy analysis. Further, blockade of granule acidification or serine protease activity prior to mefloquine treatment protected MCs from apoptosis, indicating that granule acidity and granule-localised serine proteases play major roles in the execution of mefloquine-induced cell death. Altogether, these findings reveal that mefloquine induces selective apoptosis of MCs by targeting their secretory granules and suggest that the drug may potentially extend its range of medical applications.


Asunto(s)
Mastocitosis Cutánea , Mastocitosis , Adulto , Humanos , Mastocitos/metabolismo , Mefloquina/metabolismo , Mastocitosis Cutánea/metabolismo , Vesículas Secretoras/metabolismo , Vesículas Secretoras/patología , Apoptosis , Caspasas/metabolismo
15.
Clin Exp Dermatol ; 47(9): 1694-1702, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35596520

RESUMEN

BACKGROUND: Mastocytosis is characterized by the accumulation of mast cells (MCs) in the skin or other organs, and can manifest at any age. A significant number of paediatric mastocytosis cases persist after puberty. In particular, monomorphic maculopapular cutaneous mastocytosis (mMPCM) is often persistent and associated with systemic mastocytosis. However, clinical differentiation of MPCM from polymorphic (p)MPCM can be difficult. AIM: To identify histopathological features that can help to distinguish mMPCM from other subtypes of paediatric mastocytosis. METHODS: This was a retrospective study using skin biopsies from patients with any subtype of mastocytosis. The localization and density of the MC infiltrate, MC morphology and expression of aberrant markers were evaluated and correlated with clinical characteristics. RESULTS: In total, 33 biopsies were available for evaluation from 26 children [(10 with mMPCM, 5 with mastocytoma, 3 with diffuse cutaneous mastocytosis (DCM), 8 with pMPCM)] and 7 adults with MPCM. The MC number was increased in all patients, but was higher in children than adults (P < 0.01). The presence of mMPCM was associated with sparing of the papillary dermis from MC infiltration, whereas MC density in the papillary dermis was highest in pMPCM and DCM (P < 0.01). The positive predictive value of the presence of a reticular MC infiltrate for mMPCM was 72.7% (95% CI 51.4-87.0), and the negative predictive value was 83.3% (95% CI 42.2-97.2). There were no relevant differences in the expression of CD2, CD25 or CD30 between the different subtypes. CONCLUSION: Skin histopathology might enhance the phenotypical differentiation of mMPCM from other subtypes in children, thereby increasing the accuracy of one's prognosis.


Asunto(s)
Mastocitosis Cutánea , Mastocitosis Sistémica , Mastocitosis , Urticaria Pigmentosa , Adulto , Niño , Humanos , Mastocitos/patología , Mastocitosis/patología , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/patología , Mastocitosis Sistémica/metabolismo , Mastocitosis Sistémica/patología , Proteínas Proto-Oncogénicas c-kit , Estudios Retrospectivos , Urticaria Pigmentosa/diagnóstico , Urticaria Pigmentosa/patología
16.
J Eur Acad Dermatol Venereol ; 36(8): 1367-1375, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35412687

RESUMEN

BACKGROUND: Cutaneous lesions of mastocytosis (CLM) are often subtle and may require biopsy. However, dermatohistopathological criteria for CLM remain undefined. OBJECTIVES: To establish criteria for CLM by validating histological and molecular parameters. METHODS: In skin samples from Caucasian patients with CLM and controls (atopic dermatitis, chronic urticaria, pruritus, tissue from tumor safety margin excisions), mast cell (MC) numbers, size, shape, distribution, immunostainability with a large panel of markers, pigmentation and presence of KIT D816V mutation were analysed. RESULTS: Forty-seven CLM patients (32 maculopapular cutaneous mastocytosis (MPCM), 15 mastocytomas) and 36 controls were included. Mastocytomas were easily identified by densely packed cuboidal MCs. In MPCM, skin MC density in CD117 stains was higher in CLM patients than in controls (P < 0.0001) and values correlated closely (r = 0.65, P < 0.0001) to results in tryptase stains. The optimized upper dermis cut-off number of 62 MC/mm2 had a sensitivity and specificity of 92% in both stainings, corresponding to approximately 12 MC/high power field (HPF). MC size was larger in MPCM than in controls (P = 0.01). Interstitial (= not perivascular or periadnexal) MCs and stronger basal pigmentation of the epidermis were indicative of MPCM (P < 0.0001 each) and clusters of >3 nucleated MC/HPF exclusively found in MCPM. Surface markers CD2, CD25 and CD30 stained T-lymphocytes, but only negligibly CLM MC. The KIT D816V mutation in formalin fixed paraffin embedded (FFPE) skin was evaluable in 87.5% of MCPM patients and had both 100% sensitivity and specificity. CONCLUSIONS: MPCM can be predicted by major and minor criteria combined in a scoring model. Presence of D816V mutation in FFPE skin and MC density > 27/HPF are >95%-specific major criteria for MPCM. MC densities 12/HPF, interstitial MC, clusters and basal pigmentation are minor criteria.


Asunto(s)
Mastocitosis Cutánea , Mastocitosis Sistémica , Mastocitosis , Biomarcadores , Humanos , Mastocitos/patología , Mastocitosis/diagnóstico , Mastocitosis/patología , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/genética , Mastocitosis Cutánea/patología , Mastocitosis Sistémica/patología , Mutación , Proteínas Proto-Oncogénicas c-kit/genética , Triptasas
17.
Pediatr Dermatol ; 39(2): 328-329, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35119134

RESUMEN

In the last few years, de novo mutations in the GNB1 gene have been found to cause a neurodevelopmental disorder typically characterized by global developmental delay and hypotonia. Only 4 cases of maculopapular cutaneous mastocytosis in children with GNB1 mutations have been reported to date. Here, we describe another case of the condition with concomitant cutaneous mastocytosis.


Asunto(s)
Subunidades beta de la Proteína de Unión al GTP , Mastocitosis Cutánea , Trastornos del Neurodesarrollo , Urticaria Pigmentosa , Niño , Subunidades beta de la Proteína de Unión al GTP/genética , Humanos , Mastocitosis Cutánea/complicaciones , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/genética , Mutación , Urticaria Pigmentosa/complicaciones
18.
PLoS Genet ; 15(3): e1007967, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30901340

RESUMEN

Mast cell tumours are the most common type of skin cancer in dogs, representing a significant concern in canine health. The molecular pathogenesis is largely unknown, but breed-predisposition for mast cell tumour development suggests the involvement of inherited genetic risk factors in some breeds. In this study, we aimed to identify germline risk factors associated with the development of mast cell tumours in Labrador Retrievers, a breed with an elevated risk of mast cell tumour development. Using a methodological approach that combined a genome-wide association study, targeted next generation sequencing, and TaqMan genotyping, we identified a synonymous variant in the DSCAM gene on canine chromosome 31 that is associated with mast cell tumours in Labrador Retrievers. DSCAM encodes a cell-adhesion molecule. We showed that the variant has no effect on the DSCAM mRNA level but is associated with a significant reduction in the level of the DSCAM protein, suggesting that the variant affects the dynamics of DSCAM mRNA translation. Furthermore, we showed that the variant is also associated with mast cell tumours in Golden Retrievers, a breed that is closely related to Labrador Retrievers and that also has a predilection for mast cell tumour development. The variant is common in both Labradors and Golden Retrievers and consequently is likely to be a significant genetic contributor to the increased susceptibility of both breeds to develop mast cell tumours. The results presented here not only represent an important contribution to the understanding of mast cell tumour development in dogs, as they highlight the role of cell adhesion in mast cell tumour tumourigenesis, but they also emphasise the potential importance of the effects of synonymous variants in complex diseases such as cancer.


Asunto(s)
Moléculas de Adhesión Celular/genética , Mastocitoma Cutáneo/genética , Mastocitoma Cutáneo/veterinaria , Animales , Adhesión Celular/genética , Enfermedades de los Perros/genética , Perros , Predisposición Genética a la Enfermedad/genética , Estudio de Asociación del Genoma Completo/métodos , Células Germinativas , Mutación de Línea Germinal/genética , Mastocitos/metabolismo , Mastocitos/fisiología , Mastocitoma Cutáneo/metabolismo , Mastocitosis Cutánea/genética , Factores de Riesgo , Mutación Silenciosa/genética , Neoplasias Cutáneas/genética
19.
Australas J Dermatol ; 63(1): 102-104, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34314029

RESUMEN

Treatment for telangiectasia macularis eruptiva perstans (TMEP) is often challenging due to lack of an established first-line therapy and as such is primarily focused on symptomatic relief. Omalizumab shows promise as a potential therapy for mast cell disorders; however, its efficacy in TMEP is yet to be established. This case describes a 72-year-old woman with chronic refractory TMEP achieving symptomatic remission within 4 months of commencing omalizumab therapy.


Asunto(s)
Fármacos Dermatológicos/uso terapéutico , Mastocitosis Cutánea/tratamiento farmacológico , Omalizumab/uso terapéutico , Anciano , Femenino , Humanos
20.
Vet Dermatol ; 33(4): 352-e81, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35635251

RESUMEN

BACKGROUND: Cutaneous bullous mastocytosis (CBM) is a rare disease characterised by erythroderma, bullae formation on trunk, scalp and extremities which evolve to erosions. OBJECTIVE: To describe a rare variant of cutaneous mastocytosis and treatment options. ANIMAL: A 7-month-old Yorkshire terrier puppy with erythroderma and bullae formation. METHODS: Clinical examination (including haematological, biochemical and radiographic), skin biopsy, histopathological and immunohistochemical evaluation. CONCLUSION AND CLINICAL RELEVANCE: The case fulfills the criteria of CBM, representing a rare entity that is reported to be associated with spontaneous regression. However, in severe cases treatment with systemic corticosteroids, H1 and H2 antihistamines, and masitinib can be performed.


Contexte - La mastocytose cutanée bulleuse (CBM) est une maladie rare caractérisée par une érythrodermie, la formation de bulles sur le tronc, le cuir chevelu et les extrémités qui évoluent vers des érosions. Objectif - Décrire une variante rare de la mastocytose cutanée et les options de traitement. Animal - Un chiot Yorkshire terrier de 7 mois avec formation d'érythrodermie et de bulles. Méthodes - Examen clinique (y compris hématologique, biochimique et radiographique), biopsie cutanée, évaluation histopathologique et immunohistochimique. Conclusion et pertinence clinique - Le cas remplit les critères de CBM, représentant une entité rare rapportée comme étant associée à une régression spontanée. Cependant, dans les cas graves, un traitement avec des corticostéroïdes systémiques, des antihistaminiques H1 et H2 et du masitinib peut être effectué.


Introducción - la mastocitosis bullosa cutánea (CBM) es una enfermedad rara caracterizada por eritroderma, formación de bullas en el tronco, cabeza y extremidades que evolucionan a erosiones. Objetivo - describir una variante rara de mastocitosis cutánea y opciones de tratamiento. Animal- un cachorro Yorkshire terrier de 7 meses con eritroderma y formación de bullas. Métodos - examen clínico (incluyendo hematológico, bioquímico y radiográfico), biopsia de piel, evaluación histopatológica e inmunohistoquímica. Conclusión y relevancia clínica- el caso descrito cumple con los criterios de CBM, lo que representa una entidad rara que se describe como asociada con regresión espontánea. Sin embargo, en casos graves se puede realizar tratamiento con corticoides sistémicos, antihistamínicos H1 y H2 y masitinib.


Contexto - A mastocitose cutânea bolhosa (MCB) é uma doença rara caracterizada por eritrodermia, formações bolhosas no tronco, cabeça e extremidades que evoluem para erosões. Objetivo - Descrever uma variante rara de mastocitose cutânea e as opções de tratamento. Animal - Um filhote de Yorkshire terrier de sete meses de idade com eritrodermia e formações bolhosas. Métodos - Exame clínico (incluindo avaliação hematológica, bioquímica e radiográfica), biópsia de pele, histopatologia e avaliação imunohistoquímica. Conclusão e relevância clínica - Esse caso preenche os critérios de MCB, representando uma entidade rara em que a regressão espontânea é relatada. Entretanto, em casos graves, tratamento com corticosteroides, anti-histamínicos H1 e H2 e masitinib podem ser realizados.


Asunto(s)
Dermatitis Exfoliativa , Enfermedades de los Perros , Mastocitosis Cutánea , Animales , Biopsia/veterinaria , Vesícula/patología , Vesícula/veterinaria , Dermatitis Exfoliativa/veterinaria , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/patología , Perros , Mastocitosis Cutánea/diagnóstico , Mastocitosis Cutánea/tratamiento farmacológico , Mastocitosis Cutánea/veterinaria , Piel/patología
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