Evaluation of an infant or prepubertal child with skin lesions suggestive of mastocytosis

* Persistently elevated serum tryptase, in the absence of other findings suggestive of systemic disease, does not always require bone marrow evaluation because it could be due to the presence of extensive skin involvement or concomitant hereditary alpha tryptasemia. The management of children with skin lesions of mastocytosis and an elevated tryptase is depicted in a separate algorithm, which is also found in the UpToDate topic on the clinical manifestations and diagnosis of mastocytosis in children.