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Darier sign in mastocytoma

Samuel A Der Sarkissian and Deshan F Sebaratnam
Med J Aust 2021; 214 (5): . || doi: 10.5694/mja2.50947
Published online: 15 March 2021

A 1‐year‐old boy presented with a 6‐month history of a brown plaque on his left forearm (Figure, A). His parents reported variation in the size of the plaque and a single episode of unprovoked generalised flushing. On examination, stroking the plaque led to an immediate urticated reaction (Figure, B) — a response known as Darier sign, observed in cutaneous mastocytosis. Given the episode of flushing, a serum tryptase test was completed, returning a normal result (12.6 µg/L; reference interval, < 13.5 µg/L). His presentation was in keeping with a mastocytoma. Cutaneous mastocytosis in childhood generally follows a self‐resolving course but adult presentations require exclusion of mast cell leukaemia.

  • Samuel A Der Sarkissian1,2
  • Deshan F Sebaratnam1,3

  • 1 Liverpool Hospital, Sydney, NSW
  • 2 University of Wollongong, Wollongong, NSW
  • 3 Sydney Children's Hospitals Network, Sydney, NSW


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