Solitary mastocytoma in children: a retrospective analysis of the clinical course and timing of regression

Abstract

Introduction. Solitary mastocytoma is a rare clinical variant of cutaneous mastocytosis that makes its debut in infancy and early childhood. Сhanges in clinical manifestations at different ages and the rate of regression of the disease are insufficiently covered in the literature.Aim. To study the clinical manifestations and timing of regression of solitary mastocytoma in children, through retrospective analysis.Materials and methods. We retrospectively reviewed data from 32 children aged 3 months to 9 years who were on outpatient treatment and observation at the State Budgetary Healthcare Institution “Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology of Moscow Health Department” in the period from 2016 to 2020 inclusive. Diagnosis information obtained from medical records.Results and discussion. The average age of disease onset was 2.5 ± 0.7 months. Solitary mastocytoma was observed more often in boys than in girls (1.4:1). In 81.2% of children, solitary mastocytoma clinically regressed before the age of 6 years. Delayed regression of rashes in the age range from 6 to 9 years was observed in 18.8% of children. Late correct diagnosis, lack of timely recommendations for care and treatment, traumatization of elements are factors that slow down the regression of the disease. Dermatoscopic examination can be used for dynamic observation of mastocytoma, since the patterns in the foci of regression differ from mature mastocytomas in the absence of yellow-orange areas. A pronounced brown pigment network on a yellow background can be a sign of the activity of the process and a reason for the appointment of symptomatic therapy.Conclusion. The clinical features of the modern course of solitary mastocytoma are the tendency to multiple rashes, the variety of localization and the long-lasting positivity of the Darier sign. Obviously, clinical monitoring using dermatoscopy and laboratory research methods allows to follow-up the activity of the process and promptly adjust drug treatment. To prevent delayed regression of solitary mastocytoma, traumatization of rashes of any localization should be excluded.