The microscopic examination revealed angiolymphatic invasion by tumor throughout the papillary and reticular dermis. The tumor showed glandular formation and was composed of pleomorphic and atypical epithelial cells with mucin production.
The patient's valproic acid therapy was restarted, and her pruritus was managed with hydroxyzine and menthol lotion. She underwent a bronchoscopy for her shortness of breath. A transbronchial biopsy demonstrated adenocarcinoma in both vascular and lymphatic spaces. The tumor was morphologically consistent with metastatic disease from primary breast cancer.
Patchy Erythema on the Breasts. Arch Dermatol. 2001;137(4):495-500. doi: