Extensive Cutaneous Mastocytosis After Pregnancy

Area of Science:

• Dermatology
• Oncology

Background:

• Mastocytosis is a rare disease characterized by mast cell proliferation, most commonly affecting the skin.
• Telangiectasia macularis eruptive perstans (TMEP) is an uncommon variant of cutaneous mastocytosis.

Observation:

• A 33-year-old woman presented with a six-year history of widespread tan-brown macules, unusual for TMEP due to sparing of sun-exposed areas.
• Lesions appeared after her first pregnancy, a feature not typically associated with TMEP.

Findings:

• Punch biopsies confirmed nests of CD117+ mast cells and increased basal melanocytes.
• The patient was asymptomatic, and workup ruled out systemic mastocytosis.

Implications:

• This case highlights an atypical TMEP presentation, emphasizing the need for biopsy to confirm diagnosis.
• Sunbathing was recommended as an initial treatment due to the lesions' distribution, suggesting a potential photosensitive component or management strategy.