How would you work up a patient with cutaneous mastocytosis?  

In adults, consider mastocytosis as being systemic until you prove it is not. A single normal or low-elevated tryptase does not eliminate the possibility of systemic mastocytosis. All patients should go to Heme/Onc for consideration of bone marrow biopsy and ideally high-sensitivity PCR to look for ...

Is a BM biopsy a must when there is skin involvement? I think a bone marrow biopsy for cutaneous mastocytosis is most helpful when it is in the setting of a patient being referred by dermatology for a skin biopsy result showing TMEP (telangiectasia macularis eruptive perstans) since TMEP has be...