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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 4000! You can review the archived cases and read the suggested diagnoses by users and the final comment by the contributors.
Case are uploaded each week day by 10 am UK time with the correct diagnosis will generally be posted at 8 pm UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1410- 18 November Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)
Case History: 40/F, smoker, presented with painful bilateral rash on the breasts with an erythematous reticulated appearance.
Images 1,2,3- from punch bx rt breast
Images 4,5- from punch bx left breast

6th image to be posted at 19:00 GMT

Case posted by Dr Arti Bakshi
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  Report Record
Go to records November 2015

User Feedback


Guest Romualdo

Guest Romualdo

Posted

Atypical vascular lesions. Any history of radiation of the breasts?

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Dr. Mona Abdel-Halim

Dr. Mona Abdel-Halim 508

Posted

The DDx of diffuse dermal angiomatosis can be angiosarcoma but the clinical is different. Note the lesions are painful and have a reticulated appearence.
Check this:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864042/#!po=31.2500

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Raul Perret

Raul Perret 262

Posted

Agree with diffuse dermal angiomatosis.But I would like to know if the patient didnt receive radiotherapy

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Guest Romualdo

Guest Romualdo

Posted

Mona is certainly correct! Nothing was told about radiotherapy, the rash is bilateral and has an reticulated erythematous appearance. Diffuse dermal angiomatosis too.

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Arti Bakshi

Arti Bakshi 286

Posted

Too good, Mona!!
Yes, the diagnosis is Diffuse Dermal Angiomatosis of Breast. There was no history of radiotherapy (my first thought too when I saw this case without the full history!).
DDA of breast lies within the spectrum of reactive angioendotheliomatosis. The clinical presentation is distinctive and rather consistent in the cases reported in literature. (Thanks for the reference Mona, the clinical images match perfectly with the clinical of this case!). The patients tend to have large pendulous breasts and are invariably heavy smokers. (speculated pathogenesis being local ischaemia/hypoxia/trauma). Some cases have underlying haematological conditions or peripheral vascular disease.
The lesions were so painful in this patient that she presented to the surgeons requesting bilateral mastectomy! Last I heard she has been put on isotretinoin and smoking cessation regimen.
Thanks for all your comments!
[url="http://www.ncbi.nlm.nih.gov/pubmed/23488550"]http://www.ncbi.nlm.nih.gov/pubmed/23488550[/url]

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Dr. Richard Carr

Dr. Richard Carr 622

Posted

Dear Arti, Wonderful to see you on the "faculty"
Regards
Richard

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