Axillary masses in a woman with a history of breast cancer: Dermatopathic lymphadenopathy

Abstract

The presence of axillary enlarged lymph nodes in the follow-up of a woman with a history of breast cancer should always be thoroughly indagated. Dermatopathic lymphadenopathy presents a specific pathologic pattern found within the lymph nodes and is usually associated with cutaneous rashes. Patients with various skin conditions can develop regional lymphadenopathy, which can result in the asymptomatic enlargement of the lymph nodes, especially in the inguinal, axillary and cervical regions. Dermatopathic lymphadenopathy should be considered in the differential diagnosis also in patients with minimal cutaneous findings. Dermatopathic lymphadenopathy is a benign process and management of these patients consists in simple clinical, mammographic and ultrasonographic follow-up.

Correlation Between Clinical and Histological Features of Dermatopathic Lymphadenopathy: Analysis of 39 Lymph Nodes

“…Although macrophages are a minor component, they are characteristic due to the cytoplasmic pigment (mostly melanin, some hemosiderin) that they contain. 3,11 The histological differentiation of dermatopathic lymphadenopathy from lymphoproliferative disorders is crucial. 4 Differential diagnosis of dermatopathic lymphadenopathy includes Hodgkin lymphoma, mycosis fungoides/Sezary syndrome, infectious lymphadenopathy including bacterial and viral and melanoma.…”

“…Although macrophages are a minor component, they are characteristic due to the cytoplasmic pigment (mostly melanin, some hemosiderin) that they contain. 3,11 The histological differentiation of dermatopathic lymphadenopathy from lymphoproliferative disorders is crucial. 4…”

“…Dermatopathic lymphadenopathy occurs in association with various skin disorders, including infections (tuberculosis, fungal infections human immunodeficiency virus infection, and toxoplasmosis), inflammatory skin disorders (erythrodermas, psoriasis, and atopic dermatitis), skin irritation, or many other disorders, such as sarcoidosis, lymphoproliferative issues, tumor metastases, toxic shock syndrome, pemphigus, neurodermatitis, and atrophia cutis senilis. 11 However, dermatopathic lymphadenopathy in patients without active cutaneous disorders is also reported. 7,9 It has also been reported that dermatopathic lymphadenopathy is more common in patients with extensive skin involvement.…”

Surgical treatment of recidivist lymphedema

“…Our technique is performed in accordance with the lymph node structures that are preserved by not acting directly on them, but on the ability to exchange between the superficial and deep compartment that allows fasciotomy long fibrous tissues, enhancing the effect of the action of the pump muscle [ 9 - 11 ].…”

Pautrier-Woringer disease: lipomelanotic reticulosis/dermatopathic lymphadenitis

“…The differencial diagnosis includes anthracosis, melanoma metastasis and mycosis fungoides. DL is a benign process and management of these patients consists in simple clinical, mammographic and ultrasonographic followup [6].…”