{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T18:24:40Z","timestamp":1750098280656},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,5,22]],"date-time":"2015-05-22T00:00:00Z","timestamp":1432252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with elevated basal tryptase (<jats:styled-content style=\"fixed-case\">sBT<\/jats:styled-content>) &gt;15\u00a0\u03bcg\/l and anaphylaxis may have an underlying mastocytosis. A monoclonal mast cell activation syndrome with aberrant mast cells (MC) at extracutaneous sites has been described in patients with severe hypotension or anaphylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>As <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> in patients with elevated <jats:styled-content style=\"fixed-case\">sBT<\/jats:styled-content> might be altered in the skin as well, we studied <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> in normal neck skin in anaphylaxis and urticaria patients with elevated <jats:styled-content style=\"fixed-case\">sBT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A mean of 93.1 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> 19.1) <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content>\/mm\u00b2 was counted in normal neck skin in 14 patients with anaphylaxis, 84.0 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> 13.6) in seven patients with urticaria, 142.0 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> 24.0) in two patients with eczema, 124.4 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> 43.2) in five patients with systemic mastocytosis (<jats:styled-content style=\"fixed-case\">SM<\/jats:styled-content>) in comparison with autopsy skin (39.1 <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content>\/mm\u00b2, <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> 12.4). In five of 14 (35.7%) of the anaphylaxis and three of five (60%) <jats:styled-content style=\"fixed-case\">SM<\/jats:styled-content> patients more than 25% of <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> were spindle shaped and expressed <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>25 antigen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We could show for the first time that the normal skin can harbour clonal <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> in anaphylaxis patients. Analogous to the criteria for mastocytosis, we suggest a skin score criteria including an elevated number of <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content>, spindle shape, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>25 expression, c\u2010Kit mutation and <jats:styled-content style=\"fixed-case\">sBT<\/jats:styled-content> values &gt;20\u00a0\u03bcg\/l. In patients with anaphylaxis and elevated <jats:styled-content style=\"fixed-case\">sBT<\/jats:styled-content>, skin should be biopsied and, as with the approach for mastocytosis diagnosis in the bone marrow, <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> should be analysed for their number, clonality and c\u2010Kit mutation. This approach should be confirmed in further studies. Patients with aberrant skin <jats:styled-content style=\"fixed-case\">MC<\/jats:styled-content> should be handled as mastocytosis patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.12634","type":"journal-article","created":{"date-parts":[[2015,4,21]],"date-time":"2015-04-21T06:49:33Z","timestamp":1429598973000},"page":"864-872","source":"Crossref","is-referenced-by-count":6,"title":["Anaphylaxis with clonal mast cells in normal looking skin\u00a0\u2013 a new entity?"],"prefix":"10.1111","volume":"70","author":[{"given":"A.","family":"Bretterklieber","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Beham\u2010Schmid","sequence":"additional","affiliation":[{"name":"Institute of Pathology Medical University of Graz Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. J.","family":"Sturm","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Berghold","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Statistics and Documentation Medical University of Graz Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Brezinschek","sequence":"additional","affiliation":[{"name":"Department of Hematology Medical University of Graz Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Aberer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Aberer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Medical University of Graz Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,5,22]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"291","volume-title":"World Health Organization Classification of Tumours. 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