Perivascular mast cells in urticaria pigmentosa.

We have quantified perivascular mast cells in cases of urticaria pigmentosa, urticaria, and dermal hypersensitivity reactions. To facilitate reproducibility, the mast cells were counted for a precisely defined vessel unit. These vessel units were divided arbitrarily into those < or = 55 microns and > 55 microns in largest diameters. Urticaria pigmentosa showed an average of 6.4 +/- 1.9 and 22.8 +/- 13.2 mast cells for vessel unit < or = 55 microns and > 55 microns, respectively. Urticaria yielded a lower number of mast cells: 1.5 +/- 0.2 and 2.9 +/- 0.9 for the same respective vessel units. Dermal hypersensitivity reactions revealed an average of 1.6 +/- 0.4 and 2.2 +/- 0.7 mast cells, and the normal skin showed 1.5 +/- 0.3 and 2.4 +/- 0.6 mast cells for each of the vessel units of < or = 55 microns and > 55 microns. The perivascular mast cell distributions of urticaria pigmentosa are statistically different from those of urticaria and dermal hypersensitivity reactions with p < 0.0001. No statistical difference was noted between urticaria, dermal hypersensitivity reactions, and normal skin. The percentages of vessel units < or = 55 microns with > or = 5 mast cells and vessel units > 55 microns with > or = 10 mast cells were determined for each case. The average percentage of vessel units for the former and latter in urticaria pigmentosa was 82.6% and 58.9%, respectively. Urticaria yielded 0% and 0.2%, respectively. None of vessel units in the dermal hypersensitivity reactions or normal skin contained more than 5 mast cells in vessel units < or = 55 microns and more than 10 mast cells in vessel units > 55 microns. Cases of urticaria pigmentosa can be distinguished from other cutaneous eruptions containing mast cells using a simple counting technique on Giemsa stained sections.