A Telangiectasia Macularis Eruptiva Perstans in a Child: A Rare Vascular Phenotype of Cutaneous Mastocytosis.

Abstract

Telangiectasia macularis eruptiva perstans (TMEP) is a rare vascular phenotype of cutaneous mastocytosis predominantly reported in adults; pediatric cases are exceptional and are particularly difficult to recognize in darker skin phototypes. We report the case of a 4-year-old girl who presented with subtle brown macules and faint telangiectasias, in whom dermoscopy and histopathology confirmed TMEP despite a normal serum tryptase level. Symptomatic management with antihistamines and topical tacrolimus achieved a favorable clinical outcome. This case highlights the diagnostic challenges of TMEP in skin of color and underscores the need for structured long-term surveillance.