Diffuse cutaneous mastocytosis responding to cyproheptadine

A 3-month-old male infant was referred to our department with a generalized brown, thickened leathery skin and blisters which had been present since b irth; the blisters developed recurrently at sites of minor trauma, healing without scar formation, although Darier's sign was positive. Microscopicall y, biopsy specimens showed a dense dermal band-like infiltrate with mast ce lls, whereas a biopsy from a vesicle showed subepidermal bulla formation. P hysical examination did not reveal any systemic involvement with mastocytos is and the patient was treated with cyproheptadine, which has considerable anti-serotonin activity and, interestingly, reduced the degree of blisterin g; this treatment might therefore be tried in other cases.