Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
Am Surg. 2024 Nov;90(11):3121-3124. doi: 10.1177/00031348241256082. Epub 2024 May 20.
A 40-year-old woman admitted for hyponatremia and anasarca due to decompensated cirrhosis after a recent steroid taper developed extremely painful cutaneous breast lesions clinically mimicking cellulitis and inflammatory breast cancer and was biopsy-diagnosed instead with diffuse dermal angiomatosis (DDA) of the breasts, a rare and painful disease that can be a diagnostic chameleon. This case highlights the importance of early surgical consultation and tissue biopsy to correctly diagnose the etiology of severely painful mastitis and prevent prolonged symptomology and repeated administrations of ineffective treatments. Diffuse dermal angiomatosis should be considered when suspected breast cellulitis is refractory to treatment or there is concern for inflammatory breast cancer, especially in pendulous-breasted women with comorbidities that increase susceptibility to local tissue hypoxia.
一位 40 岁女性因近期类固醇减量后失代偿性肝硬化导致低钠血症和全身性水肿入院，出现临床上类似于蜂窝织炎和炎性乳腺癌的极度疼痛的乳房皮肤病变，经活检诊断为弥漫性皮肤血管瘤病（DDA），这是一种罕见且疼痛的疾病，可能是一种具有诊断伪装性的疾病。本例强调了早期手术咨询和组织活检对于正确诊断严重疼痛乳腺炎的病因以及预防延长症状和反复给予无效治疗的重要性。弥漫性皮肤血管瘤病应在怀疑乳房蜂窝织炎对治疗无反应或担心炎性乳腺癌时考虑，尤其是在患有增加局部组织缺氧易感性的合并症的乳房下垂女性中。
