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JAMA Dermatology Clinicopathological Challenge
February 2015

Indurated Breast During Lactation

Author Affiliations
  • 1Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
JAMA Dermatol. 2015;151(2):223-224. doi:10.1001/jamadermatol.2014.2821

A healthy woman in her 40s, lactating, 5 months post partum, presented with a 1-month history of enlargement and induration of both breasts (Figure, A). A skin biopsy specimen from the breast was obtained (Figure, B). She was initially diagnosed with mastitis and received several courses of antibiotics for 2 months without improvement. Subsequently she presented with back pain, paresthesias, shooting pain in the mandibular region, and diplopia. All of these conditions improved under treatment with oral corticosteroids, but the breast enlargement continued. Laboratory test results highlighted a hemoglobin level of 7.6 g/dL and a platelet count of 80 000/μL. (To convert hemoglobin to grams per liter, multiply by 10; to convert platelets to number of cells × 109/L, multiply by 1.0.)

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