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A case of cutaneous lymphangiectasis secondary to breast cancer treatment
Author(s) -
Kaya Tamer Irfan,
Kokturk Aysin,
Polat Ayse,
Tursen Umit,
Ikizoglu Guliz
Publication year - 2001
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1046/j.1365-4362.2001.01328.x
Subject(s) - medicine , dermis , papillary dermis , ectasia , h&e stain , pathology , seroma , physical examination , erythema , mastectomy , lymphangitis , outpatient clinic , breast cancer , dermatology , surgery , cancer , complication , staining
A 55‐year‐old woman presented to our outpatient clinic for evaluation of multiple small papulo‐vesicular lesions on the left axillae. She had a history of carcinoma of the left breast in 1997 and had undergone radical mastectomy. One month postoperatively she also received radiation therapy. Physical examination revealed multiple raised, pinkish‐red, papulo‐vesicular lesions on the left axillae. The lesions were located within the field that received radiation therapy. The lesions were not associated with the mastectomy scar but were located through or parallel to the skin folds, mildly inflamed and their surfaces macerated. Due to the presence of maceration and inflammation, there was a burning sensation in the affected areas. She also had moderate lymphedema of her left arm. A small cluster of the lesions was excised for microscopic examination and the intertrigo was treated. Hemotoxylin and eosin stained sections of the lesions revealed ectatic lymphatic spaces in the papillary dermis. They were lined by normal endothelial cells. The overlying epidermis was hyperkeratotic. There was a severe, chronic inflammatory cell infiltration in the subjacent dermis ( Fig. 1). With these clinical and histological findings the patient was diagnosed as cutaneous lymphangiectasis (CL). 1Ectatic lypmhatic spaces in the papillary dermis with subjacent chronic inflammatory cell infiltrate (Hematoxylin and eosin stain, ×100) Multiple lesions were anesthetized and treated with electrodessication. At 1 month follow up, no recurrence was observed. Six months later there was no recurrence at the sites of electrodesicated and excised lesions but new lesions were observed. Oozing of clear fluid was observed from these new lesions ( Fig. 2). The lesions were treated with electrodessication and daily massage therapy was advised for the treatment of lymphedema. The patient responded well to massage therapy and the lymphedema regressed gradually. There was no recurrence of the skin lesions after 1 year. 2Oozing of clear fluid from papulovesicular lesions on the left axillae