{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:54:15Z","timestamp":1792450455505,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>The diagnosis of mastocytosis in skin biopsies can be challenging \u2010 particularly in cases with very few mast cells. More diagnostic criteria are needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We analyzed 103 skin biopsies from patients with mastocytosis and compared them with biopsies from inflammatory skin lesions and normal skin. Using CD117 immunostaining, we determined the mast cell distribution pattern, the percentage of mast cells in the inflammatory infiltrate, and the mast cell count per mm\u00b2. We found that a sheet\u2010like or subepidermal distribution of mast cells was specific for mastocytosis. The most significant feature was the percentage of mast cells and not the mast cell count. We found that a mast cell percentage above 40% was fully specific in both adults and children but lacked sensitivity, especially in adults. In children, all cases with a percentage below 40% harbored a number of mast cells above 90\u2009per mm\u00b2, allowing a straightforward diagnosis. In adults, the diagnosis was more challenging and cases with less than 40% of mast cells could be diagnosed on account of a number of mast cells above 40\u2009per mm\u00b2, with 88.5% sensitivity and 95.2% specificity. Additional signs might be useful in difficult cases. However, CD25 immunostaining was not useful.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We confirmed that the criteria currently applied in the bone marrow were not appropriate for the skin. Accordingly, we developed an algorithm for the diagnosis of mastocytosis in skin biopsies with a high level of interrater reproducibility (mean kappa 0.8).<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14573","type":"journal-article","created":{"date-parts":[[2021,10,12]],"date-time":"2021-10-12T23:49:11Z","timestamp":1634082551000},"page":"501-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Establishing diagnostic criteria for mastocytosis in skin biopsies"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0273-0050","authenticated-orcid":false,"given":"Philippe","family":"Drabent","sequence":"first","affiliation":[{"name":"Department of Pathology Necker\u2010Enfants Malades Hospital APHP Paris France"},{"name":"Sorbonne Universit\u00e9 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Polivka","sequence":"additional","affiliation":[{"name":"Department of Dermatology Necker\u2010Enfants Malades Hospital APHP Paris France"},{"name":"Centre de R\u00e9f\u00e9rence des Mastocytoses (CEREMAST) Necker\u2010Enfants Malades Hospital APHP Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4094-6258","authenticated-orcid":false,"given":"Julie","family":"Agopian","sequence":"additional","affiliation":[{"name":"CRCM [Signaling, Hematopoiesis and Mechanism of Oncogenesis CEREMAST, AFIRMM] Inserm U1068 Institut Paoli\u2010Calmettes Aix\u2010Marseille University UM105 Marseille France"},{"name":"CNRS UMR7258 Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Paul","family":"Duong Van Huyen","sequence":"additional","affiliation":[{"name":"Department of Pathology Necker\u2010Enfants Malades Hospital APHP Paris France"},{"name":"Universit\u00e9 de Paris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre\u2010Alain","family":"Thiebaut","sequence":"additional","affiliation":[{"name":"Department of Pathology Necker\u2010Enfants Malades Hospital APHP Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Dubreuil","sequence":"additional","affiliation":[{"name":"CRCM [Signaling, Hematopoiesis and Mechanism of Oncogenesis CEREMAST, AFIRMM] Inserm U1068 Institut Paoli\u2010Calmettes Aix\u2010Marseille University UM105 Marseille France"},{"name":"CNRS UMR7258 Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Hermine","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Mastocytoses (CEREMAST) Necker\u2010Enfants Malades Hospital APHP Paris France"},{"name":"Universit\u00e9 de Paris Paris France"},{"name":"Department of Hematology Necker\u2010Enfants Malades Hospital APHP Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry Jo","family":"Molina","sequence":"additional","affiliation":[{"name":"Department of Pathology Necker\u2010Enfants Malades Hospital APHP Paris France"},{"name":"Universit\u00e9 de Paris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6484-0071","authenticated-orcid":false,"given":"Sylvie","family":"Fraitag","sequence":"additional","affiliation":[{"name":"Department of Pathology Necker\u2010Enfants Malades Hospital APHP Paris France"},{"name":"Centre de R\u00e9f\u00e9rence des Mastocytoses (CEREMAST) Necker\u2010Enfants Malades Hospital APHP Paris France"},{"name":"Universit\u00e9 de Paris Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"61","volume-title":"WHO classification of tumours of haematopoietic and lymphoid tissues","author":"Horny HP","year":"2017"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-09-731893"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1586\/ehm.12.12"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.08.034"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annder.2014.08.002"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0151-9638(07)89281-7"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12536780"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.2340\/0001555571394398","article-title":"Quantitation of tryptase\u2010 and chymase\u2010containing mast cells in cutaneous lichen planus","volume":"71","author":"Harvima IT","year":"1991","journal-title":"Acta. 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