Diffuse Dermal Angiomatosis of the Breast
Location
Medical Education Building, LSUHSC-NO
Presentation Date
10-10-2019 10:00 AM
End Date
10-10-2019 12:00 PM
Description
Diffuse Dermal Angiomatosis (DDA) is a rare, benign, reactive cutaneous disorder that presents with painful ulcerations and prominent vasculature [1]. Histology consists mainly of aberrant vascular proliferation [1,2]. Predisposing factors include obesity, smoking history, cardiovascular disease, and macromastia. This patient was a 53-year-old obese female with macromastia who presented with tender, non-healing ulcers of her breasts. She was referred by her plastic surgeon for preoperative evaluation prior to a bilateral breast reduction (BBR) for musculoskeletal back strain from her macromastia. On physical exam, she had large, pendulous breasts with tender, superficial ulcerations and reticulated, erythematous to violaceous patches on medial breasts. Punch biopsy was performed, and histology revealed a superficial dermal vascular proliferation in a lobular pattern accompanied by dermal edema, mucin deposition, and minimal extravasated red blood cells. She was diagnosed with DDA based on histological results and clinical presentation. She lost approximately eight kilograms and her ulcers improved allowing her to proceed with surgery. At follow-up, she had completely healed with no evidence of DDA. DDA is thought to occur from prolonged ischemia of tissue, initiating proliferation of new blood vessels that may ulcerate and cause a patient significant discomfort. [2] Currently, there is no consensus on optimal treatment. Options include medical management, treatment of cardiovascular disease, and lifestyle changes [2]. Surgery can be pursued if conservative treatments fail [1,2]. This is one of three cases that exemplify complete resolution of DDA ulcers after surgery, however, further research is needed to determine the best treatment of DDA [1,2,3].
Recommended Citation
Thompson, David Neil, "Diffuse Dermal Angiomatosis of the Breast" (2019). Medical Student Research Poster Symposium. 40.
https://digitalscholar.lsuhsc.edu/sommrd/2019/posters/40
Diffuse Dermal Angiomatosis of the Breast
Medical Education Building, LSUHSC-NO
Diffuse Dermal Angiomatosis (DDA) is a rare, benign, reactive cutaneous disorder that presents with painful ulcerations and prominent vasculature [1]. Histology consists mainly of aberrant vascular proliferation [1,2]. Predisposing factors include obesity, smoking history, cardiovascular disease, and macromastia. This patient was a 53-year-old obese female with macromastia who presented with tender, non-healing ulcers of her breasts. She was referred by her plastic surgeon for preoperative evaluation prior to a bilateral breast reduction (BBR) for musculoskeletal back strain from her macromastia. On physical exam, she had large, pendulous breasts with tender, superficial ulcerations and reticulated, erythematous to violaceous patches on medial breasts. Punch biopsy was performed, and histology revealed a superficial dermal vascular proliferation in a lobular pattern accompanied by dermal edema, mucin deposition, and minimal extravasated red blood cells. She was diagnosed with DDA based on histological results and clinical presentation. She lost approximately eight kilograms and her ulcers improved allowing her to proceed with surgery. At follow-up, she had completely healed with no evidence of DDA. DDA is thought to occur from prolonged ischemia of tissue, initiating proliferation of new blood vessels that may ulcerate and cause a patient significant discomfort. [2] Currently, there is no consensus on optimal treatment. Options include medical management, treatment of cardiovascular disease, and lifestyle changes [2]. Surgery can be pursued if conservative treatments fail [1,2]. This is one of three cases that exemplify complete resolution of DDA ulcers after surgery, however, further research is needed to determine the best treatment of DDA [1,2,3].
Comments
Mentor: Amelia E. Bush, MD (Department of Dermatology)