Dermatoscopy of Urticaria Pigmentosa with and without Darier's Sign in Skin of Colour

Urticaria pigmentosa is the most common form of mastocytosis that often develops in infancy or early childhood. We report two male children– first, a 7-month-old child with a history of asymptomatic multiple dark colored skin lesions macules with wheals on gentle rubbing (Darier's sign) and second, a 2-year-old child with similar clinical presentation without Darier's sign. Dermoscopy showed dark brown lines in a reticulate pattern which is an exaggeration of the pigment network seen in the normal skin. The reticulate pigment network was darker and thicker in the child with positive Darier's sign. This is the first case report of dermoscopy of urticarial pigmentosa with and without Darier's sign reported in skin of colour.