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Familial Urticaria Pigmentosa

Report of a Family and Review of the Role of KIT Mutations

Fett, Nicole M., MD*,†; Teng, Joyce, MD, PhD; Longley, B. Jack, MD

The American Journal of Dermatopathology: February 2013 - Volume 35 - Issue 1 - p 113–116
doi: 10.1097/DAD.0b013e31826330bf
Extraordinary Case Report

Abstract: Cutaneous mastocytosis is a rare clinically heterogeneous disorder characterized by mast cell infiltration. Mastocytosis affects both children and adults and has been reported to occur in families. Recent data suggest that mutations in the c-kit proto-oncogene are causative of mastocytosis not only in adults but in children and familial cases as well; however, mutation analysis other than D816V is not widely available, making detection of causative mutations problematic. We present the case of a 33-year-old man with a 30-year history of persistent urticaria pigmentosa and his 2 affected children. Sequencing of KIT exons 8, 10, 11, and 17 was carried out on a skin biopsy specimen and mucosal swabs of the incident case and was negative for known KIT mutations. Additional work-up was deferred by the family. Presentation of this familial case of urticaria pigmentosa demonstrates the complexity of genetic evaluation in clinical settings. It suggests that mutations other than those reported in exons 8, 10, 11, and 17 may also result in familial mastocytosis. Presentation of this case also allows for review of the mechanism of action of causative KIT mutations and the recent literature supporting KIT mutations in childhood and familial mastocytosis.

*Department of Dermatology, Philadelphia VA Medical Center, Philadelphia, PA

Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, PA

Department of Dermatology, University of Wisconsin Madison Hospital and Clinics, Madison, WI.

Reprints: Nicole M. Fett, MD, Department of Dermatology, University of Pennsylvania, Perelman Center for Advanced Medicine, Suite 1-330A, 3400 Civic Center Boulevard, Philadelphia, PA 19104 (e-mail:

The authors declare no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins.