Acquired Symmetrical Telangiectatic Macules of the Photo-Exposed Areas: Mastocytosis or Photodamage?

An uncommon form of macular telangiectatic eruption resembling cutaneous mastocytosis, previously known as Telangiectasia Macularis Eruptiva Perstans (TMEP), is described. The lesions have a very demarcated location, affecting only sun-exposed areas. We discuss the unusual clinical presentation in a 56-year-old woman on the light of the potential pathophysiologic events. Past clinical descriptions of TMPE had a common distribution in photo-exposed areas. It created some confusion with recently described forms of acquired telangiectatic disorders. In addition, the diagnosis of TMPE has been recently object of debate. In the end, TMEP has been removed from the present World Health Organization (WHO) classification of cutaneous mastocytosis. Some reports are still controversial about the differential diagnosis between photo dermatosis, acquired telangiectatic syndromes and skin limited cutaneous mastocytosis, which may share some similar histological findings.