RESUMO
Diffuse cutaneous angiomatosis is one of the reactive angiomatoses. Historically, it is associated with lesions located in the lower extremities. Breast localization is uncommon, but may be under-reported. We report a non-smoking woman who exhibited this vascular condition of both breasts.
Assuntos
Angiomatose/patologia , Doenças Mamárias/patologia , Mama , Idoso de 80 Anos ou mais , Angiomatose/diagnóstico , Feminino , HumanosRESUMO
INTRODUCTION: Diffuse dermal angiomatosis is an entity in the spectrum of reactive angiomatoses characterized by erythematous plaques that mainly affect the lower extremities of patients with a personal history of peripheral vascular disease. Involvement of the breast is a rare event that has only been described as single cases in women with large breasts. OBJECTIVE: Our main aim is to report three rare cases of diffuse dermal angiomatosis of the breast and to better define their clinical, histopathological, and immunohistochemical characteristics. Comorbidities and management will also be discussed. METHODS: A retrospective search of patients with the diagnosis of diffuse dermal angiomatosis of the breast was made. Databases of three hospitals, Hospital 12 de Octubre (Madrid, Spain), Hospital La Fe (Valencia, Spain), and Clinica Dermatologica, University of Genoa (Italy), were included in the analysis. RESULTS: Three middle-aged women who were heavy smokers were found. Physical examination revealed several livedoid plaques on both breasts. Painful ulceration over the violaceous lesions was observed in two cases. Histological features included a diffuse proliferation of spindle-shaped endothelial cells with focal small vessel formation occupying the full thickness of the dermis with scanty extravasated erythrocytes, showing positivity for CD31, CD34, and SMA-α and negativity for D2-40. Management was focused on a strict control of comorbidities, especially on the cessation of smoking habit that led to a conspicuous improvement in all patients. CONCLUSIONS: We describe all those clinicopathologic features that define diffuse dermal angiomatosis of the breast, which should be considered a distinctive variant into the group of cutaneous angiomatoses. In our experience, a strict control of smoking habit must be the first step in the management of this entity.
Assuntos
Angiomatose/patologia , Doenças Mamárias/patologia , Dermatopatias Vasculares/patologia , Fumar , Actinas/análise , Angiomatose/terapia , Anticorpos Monoclonais Murinos/análise , Antígenos CD34/análise , Mama , Doenças Mamárias/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Molécula-1 de Adesão Celular Endotelial a Plaquetas/análise , Estudos Retrospectivos , Pele/química , Dermatopatias Vasculares/terapia , Úlcera Cutânea/etiologia , Fumar/efeitos adversos , Abandono do Hábito de FumarRESUMO
Hypertrichosis is a common feature in cutaneous porphyrias, characterized by high accumulation of photoreactive porphyrins. Photothermolysis induced by noncoherent light (755-1200 nm) and energy fluence of 42 J/cm(2) was applied to a patient with hepatoerythropoietic porphyria. Hypertrichosis was almost completely removed after seven sessions without development of skin lesions.