Only two studies have investigated VEGF protein expression in the brain of severe or CM cases.14,15 In the first study, immunohistochemical analysis of VEGF was carried out in the brain of six European adults who had died from CM.14 VEGF was found in astrocytes and VEGF receptor 1 (VEGFR1; flt-1) in Dürck’s granulomas. This evidence concerns the gene FLT1 and cutaneous mastocytosis.