Mast cells are cells of the immune system that are found around blood vessels in the skin, gastrointestinal tract, respiratory tract, and genitourinary tract. They contain granules of several substances, the most common of which is histamine. These granules are released in response to contact with certain foreign substances. In the most common form of mastocytosis, there are a greater number of mast cells in the tissues. These mast cells cause a typical skin response called urticaria pigmentosa in which a hive immediately develops after stroking the skin with a blunt object.
Symptoms of Mastocytosis
People with mastocytosis also experience symptoms throughout the body caused by the release of large amounts of histamine and other chemicals. The flushing occurs suddenly on the face and upper trunk. Many patients cannot identify a trigger that causes the flushing, but some identify exercise, heat, or emotional anxiety as a possible trigger. The red, hot face is often accompanied by palpitations, low blood pressure, dizziness, chest pain, explosive diarrhea, nausea, or fatigue. Medications such as opioid narcotics like morphine and codeine, and aspirin or other non-steroidal anti-inflammatory drugs like ibuprofen or naproxen can also start a flushing attack.
Diagnosis of Facial Flushing Caused by Mastocytosis
Mastocytosis can be difficult to diagnose. Correctly identifying the clinical symptoms aids in the diagnosis. Sometimes skin lesions and bone marrow are biopsied and the urine checked for increased levels of the chemicals contained in mast cells.
Treatment of Facial Flushing Caused by Mastocytosis
There are numerous treatment options for mastocytosis depending on the main symptoms. Antihistamines are useful in some certain types of mastocytosis. Aspirin and other non-steroidal anti-inflammatory drugs can reduce flushing symptoms, except in patients in whom these medications actually trigger flushing. Other treatment options include cromolyn sodium, ketotifen, topical steroids, and PUVA.