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A two-month-old boy was referred to our facility with numerous bullae on the skin and unilateral periorbital cellulitis. The child was inconsolable, and his skin lesions, which had been present since birth, progressed into subcutaneous nodules, plaques, and tumors, which were excoriated. He had hepatomegaly and wheezing. Findings on examination of biopsy specimens of the skin and bone marrow were consistent with the diagnosis of systemic mastocytosis. There were no bony lesions, and there
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