Abstract
Background: Diffuse dermal angiomatosis (DDA) is a rare, reactive vascular disorder of the skin. Association with vascular disease, smoking, and large pendulous breasts has been reported. No standard of care exists but benefit with medication and reduction mammaplasty has been reported. Methods: We report a case of a 49-year-old obese female with a history of smoking who presented with DDA that improved with smoking cessation and pentoxifylline prior to reduction mammaplasty. We also performed a retrospective chart review of all patients with DDA seen at our institution between 2010 and 2020. Results: Eight female patients with DDA affecting the breasts were evaluated at our institution. The mean age was 49.5 years. Five of the patients noted symptoms at presentation. Obesity was seen in 7 (87.5%) patients and 5 (63%) had a smoking history. There was no significant difference between symptomatic and asymptomatic groups in regard to age, t4=-0.63, p=0.56, but BMI trended higher in the symptomatic group, t6=2.27, p=0.06. Three patients (38%) were noted to have fibromyalgia. All symptomatic patients saw improvement in their symptoms with treatments including reduction mammaplasty (1 patient), aspirin (1 patient), pentoxifylline (3 patients), smoking cessation (2 patients), and/or weight loss (1 patient). Conclusions: Our series is the second largest series of DDA of the breasts and confirms many reported associations including obesity, smoking, and large pendulous breasts. We report the first known case of improvement with weight loss as a sole intervention, as well as identify a novel potential association between DDA and fibromyalgia.
Highlights
Diffuse dermal angiomatosis (DDA) is a rare, benign, acquired reactive vascular disorder of the skin first described in 1994 most commonly affecting middle-aged females.[1,2,3] As of early 2016, only 73 patients with DDA had been reported to date.[3]
We obtained a list of patients from the MC Research Analytics team, who did an electronic medical record (EPIC) search of “diffuse dermal angiomatosis.”
We compiled data on demographics, clinical presentation, relevant co-morbidities including body mass index (BMI), smoking history, biopsy and lab results, and any treatments used with described outcomes
Summary
Diffuse dermal angiomatosis (DDA) is a rare, benign, acquired reactive vascular disorder of the skin first described in 1994 most commonly affecting middle-aged females.[1,2,3] As of early 2016, only 73 patients with DDA had been reported to date.[3] Most case reports and series describe an association with hypoxic conditions such as vascular disease, calciphylaxis, and smoking, as well as other comorbid conditions including obesity and diabetes. Diffuse dermal angiomatosis (DDA) is a rare, reactive vascular disorder of the skin. Association with vascular disease, smoking, and large pendulous breasts has been reported. No standard of care exists but benefit from various with medications and reduction mammaplasty has been reported
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