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Oct 2011

Erythematous Patches and Plaques on the Chest With Induration of the Breasts —Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2011;147(10):1215-1220. doi:10.1001/archdermatol.2011.284-a

A 57-year-old woman presented with a 1-month history of an erythematous eruption involving the breasts and chest. The eruption initially manifested on the mid-chest and gradually spread to involve both breasts. It was asymptomatic, with the exception of mild, intermittent pruritus. Her medical history was notable for metastatic papillary renal cell carcinoma (RCC) treated with temsirolimus, which was diagnosed 3 months prior to presentation, and papillary thyroid carcinoma (multifocal follicular variant) treated with total thyroidectomy 2 years prior. Her family medical history was unremarkable. Bilateral breast ultrasonography and mammography, performed as part of metastatic disease workup, revealed benign findings. Physical examination revealed numerous erythematous patches, thin plaques, telangiectasias, and peau d ’orange appearance of the skin on the breasts (Figure 1). The inferior aspects of the breasts were indurated (Figure 2). The patient was afebrile and there were no cutaneous leiomyomas. Punch biopsies of left upper chest and left breast were performed (Figure 3).

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