VisualDx Reminds Derm Resident What to Look for to Confirm Patient’s Rash

Jasmine, a dermatology resident at Stanford University, shares how VisualDx confirmed her young patient’s diagnosis.

“I was concerned about urticaria pigmentosa in a 3-4 yo female patient and reading through VisualDx summary on this topic reminded me to do Darier’s sign, which was positive for my patient! Also reminded me to do a full review of systems.”

Urticaria pigmentosa pictured here is not the patient in this case study. See more pictures of urticaria pigmentosa in VisualDx.

What is urticaria pigmentosa?

Urticaria pigmentosa is the most common cutaneous mastocytosis in children. Mast cells accumulate in the skin, causing characteristic pruritic skin lesions. It causes generalized, persistent, pigmented lesions that urticate or wheal with any mechanical stimuli.

What to look for

• Erythematous to brown patches that become urticarial or blister upon rubbing or scratching (Darier sign)
• Lesions can be few or numerous and typically involve the trunk.
• Lesions are usually 1-2 cm.
• Lesions can have a peau d’orange appearance.

How can we treat this?

Urticaria pigmentosa can be managed by avoiding triggers which commonly include medications, physical stimuli, and foods.

Treatment can include oral antihistamines if the patient is symptomatic and topical steroids under occlusion may reduce skin lesion severity.

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