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  Vol. 142 No. 5, May 2006 TABLE OF CONTENTS
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A Slowly Enlarging, Unilateral, Erythematous Macular Lesion—Diagnosis

Arch Dermatol. 2006;142:641-646.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Unilateral telangiectasia macularis eruptiva perstans (TMEP).

MICROSCOPIC FINDINGS AND CLINICAL COURSE

The lesional biopsy specimen, which was compared with one from unaffected skin, revealed dilated upper dermal vessels with a discrete perivascular cellular infiltrate with increased mast cell numbers (range, 10-20 per high-power field) on Giemsa staining. Routine blood tests (including serum tryptase levels), abdominal ultrasound, and bone scintigraphy revealed no abnormalities. There were significant increases in the 24-hour urinary excretion of N-methylhistamine (355 µg [reference value, <172 µg]) and 1-methyl-4-imidazoleacetic acid (27.3 mg [reference value, <4.5 mg]). The overall picture was consistent with TMEP with a unilateral distribution.

Treatment was symptomatic. The patient was advised to avoid the specific triggers that might stimulate mast cell degranulation. H1 antihistamines were administered to provide relief of flushing (ebastine, 20 mg/d, plus hydroxyzine hydrochloride, 50 mg/d). After 2 years of follow-up, there were no signs of systemic involvement.

DISCUSSION

Mastocytosis is a rare disease that is characterized by a primary pathologic increase in . . . [Full Text of this Article]


RELATED ARTICLE

A Slowly Enlarging, Unilateral, Erythematous Macular Lesion—Quiz Case
Xavier Bigatà Viscasillas, Gemma Sais Puigdemont, and Carme Admella Salvador
Arch Dermatol. 2006;142(5):641-646.
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