Transient Telangiectatic Purpura after Axillary Dissection: A Postoperative Phenomenon

Abstract

© 2013 The Authors. doi: 10.2340/00015555-1547 Journal Compilation © 2013 Acta Dermato-Venereologica. ISSN 0001-5555 Telangiectasias are small dilated vessels observed after inflammatory diseases, radiotherapy and in vascular malformations, such as Sturge-Weber neurovascular syndrome (1). Purpura is a discoloration of the skin due to extravasation of red blood cells. Extravasated blood is broken down to various metabolites derived from haem within 3 weeks. Purpura can originate from platelet or coagulation disorders, elevated intravascular pressure, vasculitis or toxic reactions to drugs. Purpura lesions do not blanch on applying pressure (diascopy) (2). Treatment of metastatic malignant disease often involves regional lymph node dissection. Axillary lymph node clearance involves removal of all lymph nodes in levels I–III. The intercostobrachial sensory nerves in the area are removed, but the motor nerves (long thoracic and thoracodorsal nn.) are preserved (3, 4). Significant morbidity can be related to axillary dissection including seroma, wound infection, haematoma, neuro praxia, lymphoedema and shoulder dysfunction (3, 5). We present here 2 cases of transient purpura discoloration of the skin after axillary dissection in 2 patients with different malignancies.