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Review
. 2025 Nov;45(4):589-602.
doi: 10.1016/j.iac.2025.06.011. Epub 2025 Aug 5.

Challenges in Cutaneous Mastocytosis

Affiliations
Review

Challenges in Cutaneous Mastocytosis

Tobias Franz et al. Immunol Allergy Clin North Am. 2025 Nov.

Abstract

Cutaneous lesions of mastocytosis (CLM) are a hallmark for the diagnosis of mastocytosis. The nomenclature of the term "cutaneous mastocytosis" (CM) is ambiguous as it is used both for classification excluding and as a morphologic description including systemic variants of mastocytosis. Recognition of CLM may be delayed by clinically subtle and very heterogeneous presentations. Distinguishing monomorphic versus polymorphic maculopapular CM may be challenging. Less common presentations require a clearly positive Darier's sign, histopathological confirmation, and/or skin D816V kit mutational analysis. Management of patients with CLM requires multidisciplinary therapy, adequate staging, and follow-up to recognize complications.

Keywords: Challenges; Dermatohistopathology; Diagnosis; KIT; Maculopapular cutaneous mastocytosis; Mast cells; Mastocytosis; Urticaria pigmentosa.

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Conflict of interest statement

Disclosure The authors declare no conflict of interest regarding the content of the article. Access to original data is restricted due to data protection guidelines and can be granted on reasonable request. Funding: The research was sponsored by the authors’ departments.

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