Nummular Eczema of Breast: A Potential Dermatologic Complication after Mastectomy and Subsequent Breast Reconstruction.

Yoshiko Iwahira,Yoshio Tanaka,Tomohisa Nagasao,Yusuke Shimizu,Kumiko Kuwata

doi:10.1155/2015/209458

Abstract

Purposes. The present paper reports clinical cases where nummular eczema developed during the course of breast reconstruction by means of implantation and evaluates the occurrence patterns and ratios of this complication. Methods. 1662 patients undergoing breast reconstruction were reviewed. Patients who developed nummular eczema during the treatment were selected, and a survey was conducted on these patients regarding three items: (1) the stage of the treatment at which nummular eczema developed; (2) time required for the lesion to heal; (3) location of the lesion on the reconstructed breast(s). Furthermore, histopathological examination was conducted to elucidate the etiology of the lesion. Results. 48 patients (2.89%) developed nummular eczema. The timing of onset varied among these patients, with lesions developing after the placement of tissue expanders for 22 patients (45.8%); after the tissue expanders were replaced with silicone implants for 12 patients (25%); and after nipple-areola complex reconstruction for 14 patients (29.2%). Nummular eczema developed both in periwound regions (20 cases: 41.7%) and in nonperiwound regions (32 cases: 66.7%). Histopathological examination showed epidermal acanthosis, psoriasiform patterns, and reduction of sebaceous glands. Conclusions. Surgeons should recognize that nummular eczema is a potential complication of breast reconstruction with tissue expanders and silicone implants.

Highlights

Breast cancer is one of the most common cancers
The present paper aims to introduce clinical cases of nummular eczema that developed during the breast reconstruction process, and it discusses how we can prevent this complication
The onset timing presented variation, with 28 cases (45.8%) developing nummular eczema after placement of tissue expanders (Group 1), 12 cases (25.0%) developing lesions after replacement of expanders with silicone implants (Group 2), and 14 cases (29.2%) developing lesions after reconstruction of the nipple-areola complex (Group 3)

Summary

Introduction

Breast cancer is one of the most common cancers. For instance, in the United States, one out of eight females develops breast cancer in her life [1]. Since the breast symbolizes femininity, its loss can inflict serious psychological damage on patients. Methods of breast reconstruction are classified into two genres: reconstruction by the transfer of autologous tissues [2, 3] and reconstruction with artificial materials [4,5,6]. The latter genre is less invasive than the former. Well-known complications include exposure of expanders or silicone implants Besides these complications, we have recognized that nummular eczema may develop on the skin of the reconstructed breast, this is not widely noted. The present paper aims to introduce clinical cases of nummular eczema that developed during the breast reconstruction process, and it discusses how we can prevent this complication

Methods

Results

Conclusion