Treatment of Indolent or Smoldering Systemic Mastocytosis with Pruritus and Flushing
In patients with indolent systemic mastocytosis (ISM) or smoldering systemic mastocytosis (SSM), cutaneous symptoms — particularly pruritus and episodic flushing — represent a central management challenge that requires a structured, evidence-based approach.
Clinical scenario: Indolent or smoldering systemic mastocytosis accompanied by pruritus (skin itching) and/or flushing of the skin. Treatment goals in this population are primarily directed toward anaphylaxis prevention, symptom control, and osteoporosis management.
Third-line approach: When skin symptoms persist despite earlier measures, the structured protocol identifies specific options — one involving an anti-inflammatory agent and another a photochemotherapy modality. The full selection criteria, conditions of use, and sequencing are detailed in the complete protocol.
References
DOI: 10.1002/ajh.26962
- Treatment goals for ISM patients are primarily directed toward anaphylaxis prevention/symptom control/osteoporosis treatment.
- Aspirin (see text)
- Psoralen plus ultraviolet A (PUVA) photochemotherapy
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