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JAMA Dermatology Clinicopathological Challenge
March 27, 2019

An Elderly Woman With Violaceous Swelling With Telangiectasia and Necrosis on the Face

Author Affiliations
  • 1Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
JAMA Dermatol. 2019;155(5):615-616. doi:10.1001/jamadermatol.2018.5316

A woman in her 60s presented to the clinic with a 3-month history of pain, swelling, and erythema on her face. Eleven years earlier, she had been diagnosed with left breast carcinoma and had undergone a mastectomy with subsequent radiotherapy and chemotherapy. Seven years later, she had been found to have left supraclavicular lymph nodes metastasis and had undergone a surgical excision. On presentation for the current problem, the patient experienced pain on palpation, but denied fever, chills, or other symptoms. A physical examination revealed violaceous swelling with telangiectasia and necrosis on the forehead, eyelids, nose, and cheek, predominantly involving the left side of the face (Figure 1). A biopsy of the lesion was performed for histopathological analysis (Figure 2).

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