This is the breast of a 50 year old woman who presented with pain. It is tender, firm, and enlarged, but no masses are felt. The skin feels "thickened." There is no fever or leukocytosis.Challenge: What's the unfortunate diagnosis here?
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peau d'orange >> inflammatory breast cancer
ReplyDeleteI saw somewhere that the ddx includes cutaneous infection, sarcoidosis, or sclerederma - does that jive with what you found?
peu d' orange?
ReplyDeletegood job! i didn't read too much about the ddx (i probably should have) - but those make sense (though i still really don't know what sarcoidosis really is)
ReplyDeletePoor Prognosis
ReplyDeleteThe classic presentation of inflammatory breast cancer is a diffuse brawny induration of the skin with an erysipeloid edge usually without underlying palpable mass. This image is called a peau d’orange (skin of an orange) and generally represents inflammatory breast cancer. The skin color in this disease has a wide range. At presentation, almost all women have lymph node involvement and about 1/3 have distant metastases.
Sources: UpToDate; Loyola University Stritch School of Medicine website (meddean.luc.edu)