When to Refer a Patient for Systemic Mastocytosis, With Hussein Abbas, MD, PhD

After presenting his session at the 2025 Society of Dermatology Physician Associates (SDPA) Fall Conference, titled ‘When a Rash Is More than Skin Deep: Systemic Mastocytosis Essentials,’ Hussein Abbas, MD, PhD, spoke about his talk with HCPLive.1

In a previous interview segment, Abbas highlighted key features of systemic macrocytosis.2 In this interview segment, filmed on-site at the SDPA Fall Conference, Abbas spoke about several other key takeaways from his session and tips for clinicians considering a referral to a hematology or mast cell disease specialist.

“I think in adults, for adults, when cutaneous mastocytosis is diagnosed, there should be an immediate referral to a systemic mastocytosis specialist,” Abbas said. “Why so? Because, as I mentioned before, every patient who has cutaneous mastocytosis as an adult is likely going to have systemic mastocytosis, meaning the disease manifests in the bone marrow or other tissues other than the skin.”

Abbas emphasized the importance of immediate referral to a systemic mastocytosis specialist for adults with cutaneous mastocytosis. In pediatric cases, Abbas noted cutaneous mastocytosis can resolve, especially the polymorphic type, though the monomorphic type may persist.

“For any patient with systemic mastocytosis, the first question I [posed] is, ‘Do they need treatments?’” Abbas explained. “Because not every patient needs treatment. I think every patient needs to carry two EpiPens, epinephrine pens, because they're at risk of what we call anaphylaxis. But the actual treatment is not something they need for every patient. So if they do need treatment, we usually start with symptomatic treatment: antihistamines, cromolyn, sometimes topical steroids, and some control the symptoms.”

“Some patients respond to these options,” Abbas noted. “It may take 4, 7, 8, 9 weeks to respond, but they sometimes respond. If they don't respond and the symptom burden is high, then depending on the disease subtype, in case of skin involvement, usually this is the non-advanced subtype, although the advanced subtype could also have skin involvement.”

Later in his interview, Abbas was asked about remaining unmet needs in this particular space. He stated he would put unmet needs among patients into 3 categories.

“The first category is going to be diagnosing the disease, meaning physicians and patients, and practitioners recognizing the entity of systemic mastocytosis,” Abbas said. “This is a major unmet need, because the diagnostic test and the diagnostic expertise for this testing is not available everywhere, and it's not a classic disease that's thought about.”

In the second unmet need category, Abbas highlighted the lack of treatment options. He noted only a single drug is approved in the indolent form. Overall, he believes more treatments are needed for this condition.

“The third thing is more patient advocacy,” Abbas expressed. “We really need patients to feel empowered, to recognize their disease and recognize that what they're feeling is not normal…Why so? Because it takes around 7 to 8 years from the time a patient has symptoms until a diagnosis is confirmed, [and this is] because there's a lack of awareness.”

View the full video above to learn more. For any other information on topics such as these, view the latest conference coverage from the 2025 SDPA Fall meeting.

In this summary, quotes highlighted were edited for the purposes of clarity.

Abbas has no relevant financial disclosures of note.

References

1. Lal K. GLP1 Agonist Therapy in Dermatology. Presented at the Society of Dermatology Physician Associates (SDPA) Fall Conference, November 5-9, San Antonio, TX.

2. Abbas H. How to Recognize Systemic Mastocytosis in a Patient, With Hussein Abbas, MD, PhD. HCPLive. November 9, 2025. https://www.hcplive.com/view/how-to-recognize-systemic-mastocytosis-patient-hussein-abbas-md-phd.