Mast Cell Disease
Your child has been diagnosed with urticaria pigmentosa (UP). These skin spots often start as a
few red bumps that increase in number with time. They appear most often on the trunk, but the
face, arms, and legs can be involved as well. Over time, the areas may look brown instead of
These areas are caused by the build-up of too many mast cells in the skin. A mast cell is a cell of
the immune system that holds histamine and other chemicals that can affect the skin. If the skin
that contains the mast cells is stroked or scratched, the histamine is released. This causes redness
and swelling; or a “hive.” Sometimes, the child may have blisters where the skin was scratched
UP often begins in the first 8 months of life. During the next few months, more bumps may
appear. By age 5, the lesions do not flare and “hive” with scratching. Most of the time, you will
notice the bumps but there are no symptoms. By teen years, most lesions are either gone or have
only faint areas of brown pigment left.
There are medicines that can cause the mast cells to release histamine and cause symptoms
throughout the body, such as flushing, rapid heart rate, low blood pressure with fainting,
vomiting, and diarrhea. These medicines should be avoided.
Triggers for Mast Cell Disease
Items on this list are most often not a problem unless the mast cell disease is severe. Exposures
should be reduced in severe cases of mastocytosis.
Physical stimuli: Exercise, heat, skin friction, hot baths, hot drinks, cold exposure
(especially swimming), sunlight, emotional stress, spicy foods.
Medicines, oral and injected: Aspirin, alcohol (in cough compounds and pediatric elixers),
morphine, codeine, dextromethorphan (“DM” in cough compounds), nonsteroidal anti-
inflammatory agents,(ibuprofen, Motrin®, naproxen, Aleve®) procaine, opiates (codeine,
Demerol, morphine), thiamine, high molecular weight polymers (dextran).
Medicines, topical: Topical antibiotics containing polymyxin B.
Medicines sometimes used with general anesthesia: D-tubocurarine, scopolamine,
X-Ray Contrasts and Agents: Radiographic dyes, gallamine.
Venoms: Snakebites, bee stings, jellyfish stings.
Histamine Containing Foods: Parmesan, Blue, and Roquefort cheeses, spinach, eggplant,
some red wine, tuna, mackeral, bonita, skipjack.
Histamine Releasing Foods: Ethanol (alcohol), egg white, crustaceans (crayfish, lobsters),
chocolate, strawberries, tomatoes, citrus.
Your doctor may prescribe a strong medicated cream or ointment that will decrease the number
of mast cells in the skin. You should apply this medicine to each red/brown area on your child’s
skin twice a day for 10 days. Then stop for 10 days. If the skin spots are still present, repeat the
treatment twice a day for 10 more days, and then stop.
Your child may also be prescribed a histamine-blocking medicine to take by mouth. This should
be taken every day as prescribed by the doctor, not just when your child has symptoms. This
prevents much of the redness, swelling in the skin, and itching that comes from the excess
histamine released from the mast cells.
UP may bother your child because it is noticeable on the skin and can be itchy, but it is benign
and goes away with time. If you have further questions, please call the Pediatric Dermatology
UW Dermatology Department
1 S. Park St 7th Floor
Madison, WI 53715
Clinic: 608 287-2450
American Family Children’s Hospital
Pediatric Dermatology Specialty Clinic
1675 Highland Ave.
Madison, WI 53792
Clinic: 608 263-6420
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©10/2015. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6454