affected during embryonic or post-zygotic stage, they cause cells of skin to react and to manifest disease in the region concerned. 6 Blaschkoid pattern of mastocytosis is hypothesised to be a form of acquired cutaneous mosaicism. Cheng et al hypothesised clonal activating mutation in c-KIT must have occurred after mast cell precursors left the bone marrow and homed to the vascularised neural crest ectoderm. 7 Treatment of mastocytosis is mainly symptomatic. Avoidance of known triggering mast cell degranulation factors is important. Mast cell stabilisers such as sodium cromoglycate and Ketotifen block mast cell degranulation and histamine release. Antihistamines (H1 and H2) also provide symptomatic relief. Localised lesions can be treated with intralesional and topical steroid. Systemic steroids are used for extensive bullous mastocytosis. PUVA therapy can be an aid for cosmetic improvement in persistent lesions and symptomatic relief. 4 We present this case for the unusual presentation of adult-onset mastocytosis in a blaschkoid fashion.
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