Skin lesions can also include bullous
mastocytosis and telangiectasia macularis eruptiva perstans (multiple hyperpigmented
telangiectatic macules, located primarily on the trunk and on the extremities). In the
early form, resolution of the condition by adolescence or early adulthood is common. In
the form beginning after 5 years of age, the abnormal collections of mast cells sometimes
involves other organs. It can affect bone, gastrointestinal tract, lymphatics,
spleen, and liver, resulting in clinical signs such as abdominal pain or gastric ulcer. It
is even possible to observe an overgrowth of mast cells progressing to a malignant
out-of-control process called mast cell leukemia. Mast cells can abruptly release
vasoactive mediators, such as histamine, heparin, and prostaglandins, under some physical
stresses or in response to drugs. Severe general reaction with shock can occur.