Antihistamines are the mainstay of therapy. The leukotriene inhibitors are also used as adjunctive therapy to the antihistamines. Cromolyn is a mast cell stabilizer that is not absorbed through the gastrointestinal tract. Its use is limited to treatment of coexisting diarrhea caused by mast cell disease of the gut. Telangiectasia macularis eruptiva perstans has been treated with the 585-nm pulsed dye laser to decrease the redness and telangiectases for cosmetic purposes. Some success has been achieved in treating systemic disease with the tyrosine kinase inhibitor, imatinib. Depending on the symptoms and the body systems involved, systemic chemotherapy may be warranted to decrease the mast cell load. These agents rarely put patients into long-term remission, and the response is transient. At this point, there is no cure for mast cell disease.
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