Cutaneous mastocytosis:

Telangiectasia macularis eruptiva perstans

(TMEP)

Deba P Sarma, MD
Omaha
F 28, right medial thigh
Giemsa stain: Note the spindle shaped mast cells with
purplish granules
CD 117: Numerous mast cells showing positive stain
 Comment
 Cutaneous mastocytosis include solitary mastocytoma, diffuse
erythrodermic mastocytosis, paucicellular mastocytosis
(telangiectasia macularis eruptiva perstans [TMEP]), and
urticaria pigmentosa (UP).
 Urticaria pigmentosa is the most common form and is
characterized by multiple oval or round red-brown macules,
papules, or plaques.
 On stroking, a urticaria pigmentosa or mastocytoma lesion
becomes pruritic, edematous, and erythematous (the Darier
sign), caused by mast cell degranulation. The Darier sign is not
positive in patients with TMEP because the lesions are
paucicellular.
 In TMEP, epidermis is normal. Dermis shows spindled mast
cells best identified by Giemsa or Toluidine blue stain showing
cytoplasmic granules. Mast cells are positive with CD 117
immunostain.