Challenges in the Diagnosis of Cutaneous Mastocytosis

Brockow, Knut; Bent, Rebekka Karolin; Schneider, Simon; Spies, Sophie; Kranen, Katja; Hindelang, Benedikt; Kurgyis, Zsuzsanna; Broesby-Olsen, Sigurd; Biedermann, Tilo; Grattan, Clive E.

doi:10.3390/diagnostics14020161

Diagnostics

2024

DOI: 10.3390/diagnostics14020161

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Challenges in the Diagnosis of Cutaneous Mastocytosis

Knut Brockow,

Rebekka Karolin Bent,

Simon Schneider

et al.

Abstract: Background: Mastocytosis is characterized by an accumulation of clonal mast cells (MCs) in tissues such as the skin. Skin lesions in mastocytosis may be clinically subtle or heterogeneous, and giving the correct diagnosis can be difficult. Methods: This study compiles personal experiences together with relevant literature, discussing possible obstacles encountered in diagnosing skin involvement in mastocytosis and cutaneous mastocytosis (CM). Results: The nomenclature of the term “CM” is ambiguous. The WHO cla… Show more

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Cited by 5 publications

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Drug-like screening, molecular docking, molecular dynamics simulations, and binding free energies on the interaction of pyrazole derivatives as inhibitors of lysosomal storage disorders and anticancer activity

Edache,

Adedayo,

Dawi

et al. 2024

Discov. Chem.

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Lysosomal membrane proteins (LAMPs) are a primary target for treating tumors because of their essential role in the cancer life cycle. In this study, some computational approaches, including drug-like screening, molecular docking, and molecular dynamics (MD) simulation studies coupled with the binding free energy, have been conducted to explore the putative binding modes of pyrazole derivatives as inhibitors of lysosomal storage disorders. Certain pyrazole derivatives outperformed typical medications in molecular docking experiments against the LAMPs receptor; among other substances, molecules CID 44555488 and 45,487,645 were deemed ideal. Additionally, these ligands (CID 44555488 and 45,487,645) were projected to be orally accessible in humans after successfully passing five separate drug-likeness criteria. In the end, it was anticipated that these ligands, CID 44555488 and 45,487,645, would have minimal human toxicity and good ADMET properties, particularly in terms of GI absorption and the lack of P-gp interaction. Compounds CID 44555488 and 45,487,645 with high predicted binding affinities were subjected to further molecular dynamics simulations based on the molecular docking data, and their potential binding mechanisms were investigated. The study's description of the structure-based drug design approach will be very helpful in the creation of novel inhibitors with excellent selectivity and potency.

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Drug-like screening, molecular docking, molecular dynamics simulations, and binding free energies on the interaction of pyrazole derivatives as inhibitors of lysosomal storage disorders and anticancer activity

Edache,

Adedayo,

Dawi

et al. 2024

Discov. Chem.

View full text Add to dashboard Cite

show abstract

Flushing in children with cutaneous mastocytosis

Kasikhina,

Zhukova,

Ostretsova

et al. 2024

Medicinskij sovet

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Introduction. Flushing is a subjective feeling of warmth that is accompanied by redness of the skin on any part of the body, but mainly on the face, neck and upper trunk. Episodic flushing with other symptoms associated with mast cell mediators can be observed in 30–50% of children with cutaneous mastocytosis (CM).Aim. To analyze the frequency of flushing in children with various clinical forms of cutaneous mastocytosis. To study serum tryptase levels in children with flushing.Materials and methods. The study included data from 275 children aged from 6 months to 17 years inclusive, who were undergoing outpatient treatment and observation at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology from March 2022 until January 2024. The concentration of tryptase in the blood was determined by immunofluo-rescence on a three-dimensional porous solid phase (ImmunoCAP technology, Pharmacia Diagnostics AB, Sweden). Polarization and immersion dermatoscopy with 20x magnification were performed.Results. Flushings were observed in 17.5% of patients out of 275 observed children with CM. The level of tryptase more than 15 µg/l was determined in 20.8% of children with flushing, above 11.0 µg/l – in 37.5%. Tryptase levels were higher than 8.0 µg/L in 22 (45.8%) patients. In 25.0% of patients with flushing, tryptase levels did not exceed 5 µg/L. The severity of the vascular pattern in lesions and apparently healthy skin was characteristic of patients with frequent or prolonged flushing and tryptase levels above 8.0 µg/L.Conclusion. This study was the first in the Russian Federation to demonstrate the prevalence of flushing in children with various clinical forms of cutaneous mastocytosis. The results showed that the assessment of serum tryptase levels should be performed in all children with flushing, regardless of the clinical form of mastocytosis, including those with isolated and multiple skin mastocytomas. Clinical laboratory and dermatoscopic monitoring are important for the development of individual therapeutic tactics and prevention of mediator reactions and anaphylaxis.

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Mastocytoma and juvenile xanthogranuloma in children

Potekaev,

Kasikhina,

Ostretsova

et al. 2024

Medicinskij sovet

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The growing number of children with rare diseases such as cutaneous mastocytoma and juvenile xanthogranuloma turning to dermatologists, as well as their clinical similarity, dictate the need for specialists to pay careful attention to these diseases. cutaneous mastocytoma is a clinical form of cutaneous mastocytosis. According to the WHO classification (2022), isolated (one focus) and multiple cutaneous mastocytoma (no more than three foci) are distinguished. juvenile xanthogranuloma belongs to the group of non-Langerhans cell histiocytosis, a broad group of related diseases characterized by the proliferation of histiocytes other than Langerhans cells. We describe a case of an unusual clinical course of solitary juvenile xanthogranuloma in a 3-year-old boy referred to Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology with suspected cutaneous mastocytoma. The size, unusual shape, localization of the lesion and elevated levels of serum tryptase exceeding the age norm (<5 μg/l) determined the atypicality of this case. Dermoscopic examination revealed a central deep yellow coloration of the lesion in the center (the setting sun symptom), a vascular pattern and a clouds symptom. Pathological examination confirmed the diagnosis of juvenile xanthogranuloma. The article also reflects the results of a dynamic observation of a child with an isolated large-sized cutaneous mastocytoma. During the examination, an increase in tryptase levels (>20 μg/l), and AST values, as well as ultrasound signs of hepatomegaly were revealed. Features of the dermoscopic and pathomorphological picture demonstrated patterns characteristic of infiltration and increased activity of mast cells. Cutaneous mastocytoma and juvenile xanthogranuloma are rare and benign skin diseases that usually begin in childhood. Diagnosis of rare diseases often requires complex differential diagnosis. Features of the modern course of cutaneous mastocytoma and juvenile xanthogranuloma are an atypical clinical picture and a high risk of developing extracutaneous symptoms. The presented clinical cases demonstrate the need for interdisciplinary monitoring of patients with these diseases and change the stereotypes of treating them as independent and regressive processes without a trace.

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Challenges in the Diagnosis of Cutaneous Mastocytosis

Cited by 5 publications

References 50 publications

Drug-like screening, molecular docking, molecular dynamics simulations, and binding free energies on the interaction of pyrazole derivatives as inhibitors of lysosomal storage disorders and anticancer activity

Drug-like screening, molecular docking, molecular dynamics simulations, and binding free energies on the interaction of pyrazole derivatives as inhibitors of lysosomal storage disorders and anticancer activity

Flushing in children with cutaneous mastocytosis

Mastocytoma and juvenile xanthogranuloma in children

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