{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T05:40:47Z","timestamp":1697089247957},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2007,2,6]],"date-time":"2007-02-06T00:00:00Z","timestamp":1170720000000},"content-version":"vor","delay-in-days":67,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Skinmed"],"published-print":{"date-parts":[[2006,12]]},"abstract":"A 41\u2010year\u2010old woman presented with a 2\u2010month history of pruritus and a generalized dermatitis that developed initially on the head and spread to the trunk, legs, and buttocks. The pruritus caused extreme discomfort and was not relieved by antihistamines or topical steroid treatment. The patient denied flushing, syncope, and vomiting. Her medical history included asthma treated with salmeterol\/fluticasone propionate inhaler, and status post silicone breast augmentation. Physical examination revealed a papular dermatitis on the trunk and extremities composed of lesions up to O.S cm in diameter, surrounded by excoriation marks (Figure\u20031<\/jats:ext-link>). There was no hepatosplenomegaly or lymphadenopathy. Darier's sign was negative. Results of complete blood count, peripheral blood film examination, and liver function tests were all with normal limits. A biopsy specimen taken from a lesion and stained with hematoxylin\u2010eosin showed telangiectasias, with an increased number of mast cells around blood vessels (Figure\u20032<\/jats:ext-link>). Positive Giemsa (Figure\u20033<\/jats:ext-link>) and c\u2010kit stain (Figure\u20034<\/jats:ext-link>) indicated an increased number of mast cells. Bone marrow aspiration and total body CT performed to rule out systemic involvement showed no pathology. Protein electrophoresis was normal. Serum tryptase and histamine were within normal limits, and 24\u2010hour urine collection for histamine was normal. Narrow\u2010band UV\u2010B treatment was begun 3 times weekly, reduced to twice weekly after 2 months, and then stopped. The first few treatments resulted in significant relief of the pruritus and regression of lesions. After 3 months without treatment, the patient remained free of pruritus and lesions.<\/jats:p> Patient before treatment; skin showing papular dermatitis and excoriation marks.<\/jats:italic> <\/jats:p><\/jats:caption>image<\/jats:alt-text><\/jats:graphic><\/jats:fig><\/jats:p> Skin specimen showing telangiectasias and moderately dense perivascular infiltrate composed of lymphocytes, eosinophils, and mast cells (hematoxylineosin stain; original magnification \u00d710).<\/jats:italic> <\/jats:p><\/jats:caption>image<\/jats:alt-text><\/jats:graphic><\/jats:fig><\/jats:p> Giemsa stain highlighting cytoplasmic mast cell granules (original magnification \u00d740).<\/jats:italic> <\/jats:p><\/jats:caption>image<\/jats:alt-text><\/jats:graphic><\/jats:fig><\/jats:p> C\u2010kit (CD117) stain highlighting mast cells (original magnification \u00d720).<\/jats:italic> 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