Lupus mastitis
Systemic lupus erythematosus (SLE) infrequently presents itself as lupus panniculitis. In lupus panniculitis the subcutaneous fat tissue is involved in the inflammatory process. Lupus mastitis is again a rare variant of lupus panniculitis, probably caused by an immune-mediated inflammatory process.
In literature on the topic we can find 30 cases of lupus mastitis in men and women. Lupus mastitis may present like a breast lesion suspected to be malignant, clinically and radiologically.
In the differential diagnosis we consider inflammatory breast cancer, subcutaneous panniculitis-like T-cell lymphoma (SPTL) and diabetes mastopathy. With a medical history of SLE and signs of inflammation of the skin above the lesion however, a diagnosis of lupus mastopathy is more presumable.
Medical treatment seems more indicated in lupus mastitis, because delayed healing after surgical procedures is often reported. Even though methylprednisolone and chloroquine give clinical improvement, they need to be repeated often because of a high risk of relapse.
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