The aim of this study was to evaluate the nutritional status, especially calcium deficiency, of breastfeeding mothers of infants diagnosed with cow's milk food protein-induced allergic proctocolitis (FPIAP) on an elimination diet and to investigate the relationship between daily calcium intake and body composition of these mothers. Our prospective cohort study included 86 patients with cow's milk protein allergy (CMPA) and their mothers on an elimination diet. The mother's body fat, muscle, and water percentages were measured with the Bioelectrical Impedance Method (Tanita MC-580). All mothers were administered a diet containing an average of 2000 kcal (kilocalorie), 1000 mg of calcium, and 400 units per day of vitamin D. The final measurements were repeated 1 month later and the results of the first and second assessments were compared. The mean age of the patients included in the study was 3.8 ± 1.8 months, and the M/F (male to female) ratio was 18/17. In all, 54.3% of the patients had only CMPA, while 45.7% had multiple food allergies, including milk. A comparison of the mother's body measurements before and after the diet showed a significant decrease in fat but with an increase in calcium levels. In contrast, muscle and water ratios did not change (p < 0.001, p = 0.332, p = 0.189). Despite the recommendation of a 2000 kcal per day diet, the second evaluation found that calorie, fat, and protein ratios were significantly reduced (p = < 0.001, p = 0.011, p = 0.009, p < 0.05, respectively). The metabolic health of breastfeeding mothers who follow an elimination diet for CMPA is affected even with dietician support.

OBJECTIVE:Hospitalizations due to moderate to severe asthma exacerbations in children remain a significant burden for healthcare systems and families. Identifying factors associated with prolonged duration of hospitalization may improve asthma management and reduce morbidity. To investigate demographic and clinical factors associated with prolonged hospitalization in children admitted with moderate to severe asthma exacerbations. METHODS:This prospective cohort study included 159 children aged 5-18 years hospitalized for moderate to severe asthma exacerbations at a tertiary pediatric center between January 1 and December 31, 2024. Exacerbation severity was classified according to Global Initiative for Asthma criteria. Length of hospital stay was categorized according to the University of California, San Francisco Consensus Guidelines as short-term hospitalization (≤72 h) or prolonged hospitalization (>72 h). Demographic, clinical, laboratory, environmental, and treatment-related variables were obtained from medical records. RESULTS:Among the patients, 52.8% were female, and the median age was 8 years (IQR: 6-12). Overall, 34% had short-term hospitalization, whereas 66% experienced prolonged hospitalization. Multivariate logistic regression analysis demonstrated that weekend admission (OR: 4.564, p = 0.004), increased number of exacerbations requiring systemic corticosteroids during the previous year (OR: 1.620, p = 0.012), and longer time spent at home before admission (OR: 1.069, p < 0.001) were independent predictors of prolonged hospitalization. Female sex, tobacco exposure, obesity, polysensitization, allergic rhinitis, rhinovirus infection, and poor treatment adherence were also associated with longer hospital stay. CONCLUSIONS:Clinical severity and modifiable environmental factors contribute to prolonged hospitalization in pediatric asthma exacerbations. Early intervention, treatment adherence, and environmental control may reduce hospitalization duration and improve outcomes.

BACKGROUND:Asthma is a chronic inflammatory disease affecting multiple organ systems, including the central nervous system (CNS). Recent studies suggest an association between asthma and neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Sensory processing disorder (SPD), a neurodevelopmental condition characterized by atypical responses to sensory stimuli, may also be linked to asthma through shared inflammatory mechanisms. OBJECTIVE:This study aimed to investigate the prevalence of SPD in children with asthma as compared to those without asthma and explore its relationship with asthma severity. METHODS:This prospective, cross-sectional study included 182 children aged 5-12 years, with 91 asthmatic children in the study group and 91 nonasthmatic children in the control group. Sensory processing abilities were assessed using the Sensory Processing Measure (SPM) Home-Form. Statistical analyses, including logistic regression and path analysis, were performed to evaluate the association between asthma and sensory processing abnormalities. RESULTS:Atypical sensory processing was significantly more prevalent in asthmatic children compared to the control group across multiple sensory domains, including vision, auditory, tactile, body awareness, balance, and movement (p < 0.005). Logistic regression analysis revealed that asthma was associated with increased risk of atypical sensory processing, particularly in tactile (OR: 5.716, 95% CI: 2.9-11.3 p < 0.001) and balance/movement (OR: 8.8, 95% CI: 2.5-30.7, p = 0.001) domains. However, no significant association was found between asthma severity and SPD prevalence. CONCLUSION:Our findings suggest that children with asthma exhibit a higher prevalence of SPD, supporting the hypothesis that neuroinflammation may contribute to sensory processing abnormalities. These results highlight the need for multidisciplinary approaches in managing asthmatic children, considering both respiratory and neurodevelopmental aspects. Further research is warranted to explore underlying mechanisms and potential interventions.

Background/aim: The incidence of cat allergies in children has increased over the years. Children with cat allergies have mostly reported respiratory symptoms. The skin prick test (SPT) is the most preferred method to demonstrate sensitization to allergens. However, not all children who develop cat sensitization due to environmental exposure become allergic to cats. In our study, we aimed to determine the frequency of sensitization to cat and cat allergy, cat-related symptoms, and the cut-off value for the SPT that may indicate cat allergy. Materials and methods: Patients aged 2-18 years, who applied to the Health Sciences University İzmir Dr Behçet Uz Pediatrics and Surgery Training and Research Hospital and Balıkesir University Application and Research Hospital Pediatric Allergy outpatient clinics between January 01, 2019 and December 31, 2020, were included in the study. Patients who underwent SPT and found to be sensitized to cat allergen, were evaluated retrospectively. Clinical and laboratory findings of the patients were recorded. Receiver operating characteristics (ROC) analysis was performed to determine the cut-off value for the SPT. Results: Sensitization to cat was detected in 140 (4%) out of 3499 patients who underwent SPT. The median age of the patients was 12 years (min-max: 5-18) and 67.1% were male. Eighty-eight (62.9%) patients were symptomatic upon contact with cats, predominantly with nasal symptoms. These patients had significantly larger cat SPT wheal size than asymptomatic patients. The cut-off value was determined as 5.5 mm with a sensitivity of 72.7% and a specificity of 61.5% (95% CI, 60.5%-78.4%). Symptoms resolved in about half of our patients by reducing contact with cats. Conclusion: The present study is the first to report the frequency and clinical findings of cat sensitizations and allergies in Turkish children. For effective treatment, cat allergy must be diagnosed. In this regard, the use of a practical, readily accessible 5.5 mm cut-off point on the SPT may be helpful.

Objective: In a large group of patients with primary immunodeficiency (PID), immunoglobulin replacement therapy is critical for infection control. There are two main methods of immunoglobulin replacement intravenous (IVIG) and subcutaneous (SCIG). The aim of this study was to determine the efficacy of SCIG by comparing IgG levels and frequency of infections obtained during SCIG replacements in patients with PID with those obtained during IVIG administration. Method: Immunoglobulin levels of 28 patients who were followed up in our clinic with a diagnosis of PID and who started IVIG replacement and switched to SCIG replacement after follow-up, were evaluated retrospectively. Serum IgG levels and frequency of infections before starting immunoglobulin treatment, the previous year of IVIG before starting SCIG replacement, and during the first six months, second six months, and second year of SCIG replacement were compared. Results: The mean age of all the patients that received SCIG was 10.5 years (min 15 months, max 23 years) and eleven of the patients were female. The mean serum IgG level of the patients before starting immunoglobulin replacement was 701±383 mg/dl, and for the final year they received IVIG replacement before switching to SCIG replacement it was calculated to be 900±342 mg/dl. The mean value was found to be 1082±312 mg/dl in the first six months after the initiation of SCIG, 1102±287 mg/dl in the second six months, and 1145±311 mg/dl in the second year. Serum IgG levels of the patients were significantly higher during IVIG and SCIG replacement than before treatment (p<0.05). Serum IgG levels during the first six months, second six months, and second year of SCIG treatment were significantly higher than levels during IVIG treatment (p=0.000, p=0.003, and p=0.002, respectively). Conclusion: Compared to IVIG replacement, significantly higher and more stable serum IgG levels can be obtained with SCIG replacement. This is expected to ensure improved outcomes in the management of infections in PID patients.

BACKGROUND Food allergy (FA), hence the incidence of food anaphylaxis, is a public health problem that has increased in recent years. There are still no biomarkers for patients with FA to predict severe allergic reactions such as anaphylaxis. OBJECTIVE There is limited information on whether regulatory T (Treg) cell levels are a biomarker that predicts clinical severity in cases presenting with FA, and which patients are at a greater risk for anaphylaxis. METHODS A total of 70 children were included in the study: 25 who had IgE-mediated cow's milk protein allergy (CMPA) and presented with non-anaphylactic symptoms (FA/A-), 16 who had IgE-mediated CMPA and presented with anaphylaxis (FA/A+) (a total of 41 FA cases), and a control group consisting of 29 children without FA. The study was conducted by performing CD4+CD25+CD127loFOXP3+ cell flow cytometric analysis during resting at least 2 weeks after the elimination diet to FA subjects. RESULTS When the FA group was compared with healthy control subjects, CD4+CD25+CD127loFOXP3+ cell rates were found to be significantly lower in the FA group (p < 0.001). When the FA/A- and FA/A+ groups and the control group were compared in terms of CD4+CD25+CD127loFOXP3+ cell ratios, they were significantly lower in the FA/A- and FA/A+ groups compared to the control group (p < 0.001). CONCLUSIONS Although there was no significant difference between the FA/A+ group and the FA/A- group in terms of CD4+CD25+CD127loFOXP3+ cells, our study is important, as it is the first pediatric study we know to investigate whether CD4+CD25+CD127loFOXP3+ cells in FA predict anaphylaxis.

Background. - Cold urticaria (ColdU) is a subtype of chronic inducible urticaria. Although cold urticaria is rare in children, it has a special importance because it can result in anaphylaxis. Since it is difficult to protect patients from cold for many years, the prognosis of the disease is curious.Objective. - We aimed to evaluate the clinical features and prognosis of children with cold urticaria.Methods. - Patients with cold urticaria who were followed up in our pediatric allergy and immunology clinic between 2006 and 2020 were retrospectively evaluated. The reaction was divided into three groups according to the severity of symptoms: type 1; urticaria and/or angioedema at the contact site; type 2; diffuse urticaria and/or angioedema without other systemic symptoms; and type 3; other systemic reactions compatible with anaphylaxis.Results. - Our study included 21 patients, 52.4% of whom were male, with a mean age at diagnosis of 10.8 & PLUSMN; 4.3 years (4-18 years). The median follow-up period of the patients was 36 months (24-62 months). Localized cold urticaria was detected in 57.1% of the cases. Type 2 reaction was found in 14.3% of the cases and Type 3 reaction was found in 28.6%. In 6 cases, there was a history of anaphylaxis (Type 3). Remission developed in four (19%) patients, symptoms decreased in 6 (28.6%) patients, and symptoms persisted in 9 (42.9%) patients.Conclusion. - Children with cold urticaria are at high risk of systemic reactions and unfortunately the disease tends to persist. Detailed guidelines are needed for follow-up and treatment considering that elimination is very difficult in children.& COPY; 2022 Elsevier Masson SAS. All rights reserved.

Objective: Hereditary Angioedema (HAE) is a rare but life-threatening disease. It is aimed to present data on the clinical characteristics of our pediatric patients with HAE, whose symptoms usually start in childhood, but the delay in diagnosis is still a serious problem. Method: Clinical and laboratory findings, family histories, and clinical characteristics of 14 patients with HAE diagnosed in our clinic between 1998-2019 were analyzed. Results: Half of our patients diagnosed with HAE were girls, 78.5% of them were diagnosed with HAE type 1, and 21.4% were HAE type 2. All our patients had a family history, and 10 of them were diagnosed based on their family history. The mean age at diagnosis was 9.7±4.4 years and the mean age at the onset of the first angioedema symptom was 5.3±1.8 years. The delay in diagnosis was 4.4±4.1 years. The swollen areas included extremities (78.5%), abdominal attacks (71.4%), facial edema (57.1%), and laryngeal edema (21.4%). C4 levels were low in all patients. The mean C1 esterase inhibitor level was 0.69±0.08 g/l for HAE type 2 and 0.08±0.04 g/l for HAE type 1. The mean C1 esterase inhibitor functional activity level was 18.6±10.4% in HAE type 2. Conclusion: Early diagnosis of the disease is critical for reducing morbidity and mortality due to attacks. There are very few studies in Türkiye that focus exclusively on pediatric HAE patients. Sharing our patients’ clinical findings and treatment plans for this rare disease is crucial for bringing the disease to light and raising awareness.

BACKGROUND Tolerance of baked milk indicates a good prognosis in IgE-mediated cow's milk allergy. OBJECTIVE The present study aims to investigate the predictors of baked milk tolerance, particularly the amount of milk tolerated in the first oral food challenge (OFC) test, in children with IgE-mediated cow's milk allergy. METHODS The study included 35 cases who were diagnosed with IgE-mediated cow's milk allergy upon open OFC testing in the Pediatric Allergy Clinic. Four weeks after the diagnosis, skin prick test (SPT) and OFC were performed with baked milk. Cases who did and did not develop reactions during OFC with baked milk were compared regarding clinical and laboratory parameters. RESULTS Twelve cases (33.3%) did not develop a reaction during OFC with baked milk. Those who had low levels of casein sIgE, β-lactoglobulin sIgE, and β-lactoalbumin sIgE; small SPT wheal diameter for baked milk and β-lactoalbumin; and a large amount of unheated milk tolerated in the first OFC were found to be tolerant to baked milk (p < 0.05). For predicting baked milk tolerance, a cut-off level of the amount of unheated milk tolerated in OFC was calculated as 620 mg [with the area under the curve (AUC) 0.88 (95% confidence interval 0.77-0.99) in ROC curve analysis]. CONCLUSIONS If a child with cow's milk allergy is able to tolerate more than 620 mg of milk protein during challenge with unheated milk, this may show that this child will tolerate baked milk, meaning that the child will be able to tolerate cow's milk in the future.

Acute asthma exacerbations (AAE) are episodes characterized by potentially life-threatening and rapidly deteriorating asthma symptoms. Viral respiratory infections are one of the major triggers in the pathophysiology of childhood asthma exacerbations. In this study, we aimed to determine the distribution of viral agents among pediatric AAE patients. One hundred and three AAE patients, aged 5 or older, hospitalized between from February 2017 through February 2020 at Pediatric Immunology and Allergic Diseases Unit were included in this study. Fifty patients (48.5%) were female, and the mean age of the patients was 108.2 months. Viruses were detected in 58 (%56.3) of the patients, in 5 of whom more than one virus type was detected. The most commonly detected virus was human rhinovirus (n=43, 67.1%). Other types included respiratory syncytial virus (n=8; 12.5%), influenza (n=6; 9.3%), human metapneumovirus (n=4; 6.2%), adenovirus (n=1; 1.5%), enterovirus (n=1; 1.5%), and parainfluenza (n=1; 1.5%). Viral agents were detected in 29 out of the 47 patients with allergic asthma, with human rhinoviruses comprising the majority (18 patients). The mean length of hospital stay was 7.89 days. Human rhinovirus is the most common virus that triggers AAE, with similar distributions in allergic and non-allergic asthma. We found no correlation between virus type and the length of hospital stay.

Amaç: Astım, çocukluk çağı kronik hastalıkları arasında en sık görülen ve reversibl hava yolu obstrüksiyonu ile karakterize enflamatuvar bir hastalıktır.Çalışmamızda astım tanısı kesinleştirilen çocukların ilk kez astım semptomlarının hangi yaşta başladığının

PurposeAllergy to legumes and tree nuts (TNs) is one of the most important causes of fatal and near-fatal food-induced allergic reactions. However, our knowledge of the clinical features of legumes and TNs allergies in children is limited. In this study, we aim to identify clinical characteristics, development of tolerance, risk factors of legumes and TNs allergies in children.MethodsThis retrospective study was designed at two cities at the west part of Turkey. Fifty-seven children with legumes and TNs diagnosed at Clinic of Pediatric Allergy of Balikesir University and Dr Behcet Uz Children Hospital for 2014–2018 years were examined. Current age, gender, age of onset of the legumes and/or TN allergy, the type of the allergic reactions, family history of atopy, results of skin prick test (SPT), and/or oral challenge test and presence of concomitant food allergies, tolerance development and cross reactions were recorded.ResultsIn total, 83 allergies related with legumes and TNs were determined in 57 patients. Mean age of patients was 18.75±13 months and 40.4% were girl. Fifty-two of these reactions were related with legumes (62.6%) and 29.9% of patients had reaction with more than one. Peanut allergy was most common in legumes allergy (53.8%) and walnut allergy was most common in TNs allergy (54.8%). Urticaria was most common type of allergic reaction (56.6%), 28.9% of reactions were anaphylaxis. No statistically significant difference was found between legumes and TNs in terms of the frequency of development of anaphylaxis (P=0.062). Concomitant food allergy was present 80.7% of patients. Patients with legume allergy had significantly high hazelnut and walnut allergy (P=0.04, P<0.001, respectively). Significantly, high peanut and lentil allergy were detected in patients with TNs allergy (P=0.01, P=0.026, respectively). There was co-sensitization and co-allergy between legumes and TNs in children as expected. Tolerance development was shown in 12.2% of patients.ConclusionsIn addition to other food allergies, legumes/TNs allergies are also observed to occur with increasing frequency in children. Co-sensitization and co-allergy between legumes and TNs are frequent. Tolerance development for legumes/TNs allergies is expectedly low.

Study objective:The lockdown imposed on children due to the COVID-19 pandemic and their inability to attend school increased their exposure to indoor allergens by causing them to spend more time indoors. In this study, the aim was to reveal the effect of the pandemic and increased exposure to indoor aeroallergens on the symptom severity of school-age children with house dust mite-sensitized allergic rhinitis (AR).Patients and methods:Patients between the ages of 6-18-years old, who were followed-up with the diagnosis of perennial AR sensitized to only mites were questioned about their sinonasal symptoms. The Total Nasal Symptom Score (TNSS) questionnaire was performed. The clinical findings, drug usage, frequency of infections and attacks were evaluated and compared during COVID-19 lockdown and the same time frame in 2019.Results:Sixty-five patients had AR, and 33 patients (50.8%) had AR with asthma. TNSS of the patients improved during the pandemic (P < 0.001) and their medication scores decreased significantly (P < 0.001). The frequency of respiratory tract infections and asthma attacks decreased significantly (P < 0.001). In multivariate analysis, risk factors were evaluated for the 'group with worsening TNSS' and coal/wood burning was detected to be an independent risk factor (P = 0.006; OR = 10.09 (95% CI: 1.97-51.87)).Conclusion:Although the increased stay at home, it is surprising that nasal symptoms improved in our patients. This result suggests that whereas allergen sensitivity is responsible for the pathogenesis of AR, exposure to pollution and viral infections which are reduced by masking and social distance may also play an important role in the pathogenesis.

Objective: To evaluate the prevalence and the risk factors of allergic rhinitis in a particular area. Methods: The main study group consisted of all school children in Kemalpasa district aged 13-14 years. Children with current rhinitis based on responses given in ISAAC questionnaire survey were further evaluated for confirmation. Parents responded to a more detailed questionnaire about allergic diseases and risk factors. Then peak nasal inspiratory flow (PNIF) was evaluated to objectively assess nasal patency. Skin-prick test was performed for ten common allergens. Results: The questionnaire was answered by 90.8% (1373) of children. The prevalence of physician-diagnosed AR was 11.1%. Current rhinitis was found to be 31.3%. Of this group, 55.0% were admitted for the parent questionnaire and tests. Precisely, 90.3% of children accepted PNIF evaluation, and %10.1 of them had a nasal obstruction. Skin-prick tests revealed allergy for at least 1 allergen in 16.6% of children. The present study showed that the children with maternal allergic rhinitis history had 2,18 fold, and the children with seasonal allergic rhinitis had 2,11 fold higher possibility of sensitization to an allergen. The probability of perennial allergic rhinitis was 3,1 fold higher in the children who had siblings with allergic rhinitis. Conclusion: We included all children in a specific age group living in an area in our survey. As well as we found the prevalence of current rhinitis with the ISAAC questionnaire; we also evaluated peak nasal inspiratory flow and used skin-prick tests that yielded objective results.

Objective: Asthma is one of the most common chronic diseases of childhood. Many studies have shown that education positively affects asthma control and patients’ quality of life. In this study, it was aimed to measure the awareness levels of children who have been under observation for a long time and who underwent Allergen Specific Immunotherapy (AIT). Methods: Patients with asthma, asthma & allergic rhinitis and/or rhinoconjunctivitis who received subcutaneous AIT between July 2019 and December 2019 were included in our prospective case-control study. A questionnaire was applied to each patient, in which both the levels of awareness related to their disease and AIT, as well as their knowledge of the allergens and prevention measures they were sensitive to were measured. The results were examined. Age, gender, type of allergic diseases, allergen type, AIT time were evaluated statistically. Results: 82 cases (48 boys and 34 girls) were included in the study. The number of patients who know the name of the disease correctly is 68 (82.9%); The number of patients who knew allergens to be sensitive was found to be 47 (57.3%). It was observed that 15%-72% of the cases had information about asthma disease. Age, gender and diseases of the patients were not statistically different. Conclusion: In our study, it was observed that our children were highly aware of especially about sports and environmental protection methods. It is essential to raise awareness of patients and parents for increase treatment success and control the asthma.

Background: Drug allergies are reactions within the context of drug hypersensitivity reactions, which are caused by immunological mechanisms due to a previously sensitising drug. Beta-lactam antibiotics (BLA) are the leading agents causing drug hypersensitivity reactions in children. The aim of this study is to evaluate the diagnostic importance of in vivo and in vitro diagnostic tests in children with suspected immediate-type BLA hypersensitivity and to investigate the frequency of their use for the final diagnosis. Methods: Patients admitted to the Outpatient Clinic of Division of Paediatric Allergy and Immunology with suspicion of immediate-type BLA hypersensitivity between December 2014 and December 2018 were investigated. Patients with a history of immediate reactions to BLA were examined by performing drug specific IgE, skin prick tests, intradermal tests and drug provocation tests (DPT). Results: During the study period, 148 patients were admitted to our clinic with suspected immediate-type BLA hypersensitivity. Forty-eight patients completed all assessment steps and were enrolled in the study. It has been shown that 27 patients did not have drug allergy. BLA hypersensitivity was proven in 21 patients by using in vivo test algorithm. More than half of the patients were diagnosed via skin tests with culprit drug. Conclusion: Allergy work-up should be performed in patients with immediate reactions to BLA. A skin test can demonstrate BLA hypersensitivity in most patients. Thus, skin tests should be performed prior to the drug provocation test. (C) 2020 SEICAP. Published by Elsevier Espaa, S.L.U. All rights reserved.

Aim: Allergic sensitization in infancy generally develops against food allergens. We aimed to investigate the frequency of aero-allergens sensitization at older ages in infants with food allergy. Material and Methods: This retrospective cross-sectional study was conducted in Dr. Behçet Uz Children’s Allergy Clinic. Infants with confirmed IgE-mediated food allergy between January 1st, 2004, and December 31st, 2016, were evaluated for aero-allergen sensitivities through skin prick tests (SPT) after at least two years after diagnosis, and the data were compared with a healthy control group. Results: A total of 187 cases, 87 of which were patients, were included in the study. The cause of food allergies was cow’s milk only in 24 (27.6%) cases, egg only in 26 (29.9%) cases, both cow’s milk and egg in 33 (37.9%) cases, fish only in two cases (2.3%), and both fish and egg in two (2.3%) cases. The mean age at which the aero-allergen SPT was performed was 65 (46–180) months in the patient group and 72 (48–132) months in the healthy control group. In the patient group, 39 (44.8%) had aero-allergen sensitization, whereas, in the healthy control group, five (5%) had aero-allergen sensitization. Aero-allergen sensitization was more frequent in the patient group (p<0.05). There was no statistically significant difference in the type and number of food allergies and the development of aero-allergen sensitization (p>0.05). Conclusion: In infants with food allergies, sensitization may develop with aero-allergens at an early age. Clinical follow-up of these patients may be important in terms of allergic respiratory diseases.

Cutaneous mastocytosis is one of the diseases that will be considered in the differential diagnosis of patients presenting with urticarial plaques and common bullae. Its differential diagnosis should be made among other potential conditions such as bullous impetigo, bullous pemphigoid or eczematous eruptions accompanying immune deficiencies. The close follow up of evolution of specific lesions with detailed anamnesis, and physical examination the diagnosis of cutanous mastocytosis should be considered in priority. Detection of Darier’s sign is also helpful during examination. Definitive diagnosis can only be established after performing a skin biopsy. Here, we present a 2.5 month-old infant with cutanous mastocytosis and discuss differential diagnosis and therapeutic features in light of current literature.