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Acquired lymphangiectasis following surgery and radiotherapy of breast cancer.

Rao AG - Indian J Dermatol (2015 Jan-Feb)

Bottom Line: After 4 years of combined therapy, she developed multiple vesicles and bullae.AL is usually asymptomatic, but trauma may cause recurrent cellulitis.Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, SVS Medical College, Mahbubnagar, Andhra Pradesh, India.

ABSTRACT
Acquired lymphangiectasia (AL) is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.

No MeSH data available.


Related in: MedlinePlus

Purple and translucent vesicles and hypertrophic pedunculated bullae
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Figure 2: Purple and translucent vesicles and hypertrophic pedunculated bullae

Mentions: A 40-year-old woman was reported with multiple vesicles and bullae on the front and right side of the chest for 2 years. She was diagnosed as a case of infiltrating duct cell carcinoma of the right breast in the year 2006 for which she underwent radical mastectomy followed by the radiotherapy. She noticed the vesicular eruption 4 years after surgery and radiotherapy. Cutaneous examination revealed the absence of the right breast (post mastectomy). Multiple grouped vesicles and bullae were spread over the right anterior, lateral wall of the chest, and the hypochondrium. A Y-shaped scar was noticed in the middle of the right mammary region (mastectomy scar) with no evidence of lymphedema underneath [Figure 1]. Few of the vesicles and bullae were purple in color; pedunculated, and hypertrophic [Figure 2]. The clinical findings prompted us to diagnose AL. However, lymphangioma circumscriptum (LC), lymphangiomatous cutaneous metastases, and angiosarcoma were considered in the differential diagnosis. Histopathological examination of skin biopsy revealed, numerous dilated lymphatics in the superficial and papillary dermis lined by flattened endothelial cells, with mild hyperkeratosis consistent with diagnosis of lymphangiectasia [Figures 3 and 4]. Immunohistochemistry with podoplanin (specific marker for lymphatic endothelium) could not be carried out due to paucity of funds. She was managed with electrodessication.


Acquired lymphangiectasis following surgery and radiotherapy of breast cancer.

Rao AG - Indian J Dermatol (2015 Jan-Feb)

Purple and translucent vesicles and hypertrophic pedunculated bullae
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318044&req=5

Figure 2: Purple and translucent vesicles and hypertrophic pedunculated bullae
Mentions: A 40-year-old woman was reported with multiple vesicles and bullae on the front and right side of the chest for 2 years. She was diagnosed as a case of infiltrating duct cell carcinoma of the right breast in the year 2006 for which she underwent radical mastectomy followed by the radiotherapy. She noticed the vesicular eruption 4 years after surgery and radiotherapy. Cutaneous examination revealed the absence of the right breast (post mastectomy). Multiple grouped vesicles and bullae were spread over the right anterior, lateral wall of the chest, and the hypochondrium. A Y-shaped scar was noticed in the middle of the right mammary region (mastectomy scar) with no evidence of lymphedema underneath [Figure 1]. Few of the vesicles and bullae were purple in color; pedunculated, and hypertrophic [Figure 2]. The clinical findings prompted us to diagnose AL. However, lymphangioma circumscriptum (LC), lymphangiomatous cutaneous metastases, and angiosarcoma were considered in the differential diagnosis. Histopathological examination of skin biopsy revealed, numerous dilated lymphatics in the superficial and papillary dermis lined by flattened endothelial cells, with mild hyperkeratosis consistent with diagnosis of lymphangiectasia [Figures 3 and 4]. Immunohistochemistry with podoplanin (specific marker for lymphatic endothelium) could not be carried out due to paucity of funds. She was managed with electrodessication.

Bottom Line: After 4 years of combined therapy, she developed multiple vesicles and bullae.AL is usually asymptomatic, but trauma may cause recurrent cellulitis.Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, SVS Medical College, Mahbubnagar, Andhra Pradesh, India.

ABSTRACT
Acquired lymphangiectasia (AL) is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.

No MeSH data available.


Related in: MedlinePlus