Diffuse dermal angiomatosis of the breast

Abstract

Diffuse dermal angiomatosis of the breast can be a painful, irritating, and persistent inflammatory condition. It tends to present in middle age and is associated with a number of risk factors, mainly relating to tissue hypoxia. There are no standard treatment guidelines, and current treatment focuses on mitigating tissue hypoxia by addressing atherosclerosis through lifestyle changes and medical and/or surgical intervention. Herein, we present a case of diffuse dermal angiomatosis of the breast, describing the condition and current treatment approaches and the likelihood that this diagnosis is more common than previously believed.

A tale of a reticulated erythematous patch on the breast

“…5 Subclinical torsion, compression, repeated microtrauma and increased pressure of large pendulous breasts contribute to chronic hypoxia of focal breast tissue. 2,5 Furthermore, our patient and 27 % of described cases in the literature were heavy smokers. 5 Indeed, smoking is known to cause endothelial dysfunction and a procoagulant state contributing to vascular damage and hypoxia.…”

“…It was recently recognised as a distinct rare variant of reactive angioendotheliomatosis with different pathological features. 1,2 It is mostly located on the extremities but there is recently an increase in the reporting cases of the breast. 2 It affects middle-aged women and clinically presents as reticulated, erythematous plaques that are usually multiple and bilateral.…”

“…1,2 It is mostly located on the extremities but there is recently an increase in the reporting cases of the breast. 2 It affects middle-aged women and clinically presents as reticulated, erythematous plaques that are usually multiple and bilateral. Superficial painful ulcerations may occur over the plaque, as in our case, and moreover, induration and necrosis of the plaque may also occur in some advanced cases with severe and chronic tissue hypoxia.…”

Surgical intervention for diffuse dermal angiomatosis of the breast

“…Emphasis has been also placed on preventative measures to target tissue hypoxia such as smoking cessation and weight loss. 2 , 3 , 5 …”

“…DDA of the breast tends to affect individuals aged 40-60 years with multiple atherosclerotic risk factors such as hypertension, hyperlipidemia, diabetes mellitus, a chronic smoking history, and antiphospholipid syndrome. 1 , 2 , 3 , 4 …”