Although the evidence as to the underlying pathogenesis of this microscopic presentation remains inconclusive, one logical explanation refers to the effects of several cytokines , IL-5, tumor necrosis factor-a, CC chemokine macrophage chemotactic protein-1, and the CXC chemokine IL-8) produced by mast cells in recruiting and activating other cells in the inflammatory microenvironment, including lymphocytes, neutrophils, and eosinophils. 5 References 1 Valent P. Diagnostic evaluation and classification of mastocytosis. Immunol Allergy Clin North Am 2006; 26: 515-534. 2 Akiyama M. A clinical and histological study of urticaria pigmentosa: relationships between mast cell proliferation and the clinical and histological manifestations. J Dermatol 1990; 17: 347-355. 3 Dunst KM, Huemer GM, Zelger BG, et al. A new variant of mastocytosis: report of three cases clinicopathologically mimicking histiocytic and vasculitic disorders. Br J Dermatol 2005; 153: 642-646. 4 Ortonne N, Wechsler J, Bagot M, et al. Granuloma faciale: a clinicopathologic study of 66 patients. J Am Acad Dermatol 2005; 53: 1002-1009. 5 Krishnaswamy G, Ajitawi O, Chi DS. The human mast cell: an overview. Methods Mol Biol 2006; 315: 13-34.Nodular hidradenoma of the wrist with spontaneous regression in a 7-month-old infant e588