PMC3869495_01
Recall dermatitis: anterolateral view of the thorax.
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Three months later in July 2010, she was noted to have rapidly developed (no more than two weeks after the patient felt the first symptoms of skin stiffness and a local burning sensation) a series of ulcers on the previous mastectomy scar, which had changed in colour (hyper and dispigmentation) and elasticity (stiffness and extreme fragility) over the skin of the previously irradiated area in the left hemithorax ( Figure 1).
Punch skin biopsy: ulcer clearly present (arrow 1) over granulation tissue.. The area with preserved epidermis (arrow 2) shows acanthosis (arrow 3) and parakeratosis with loss of epidermal ridges. Vascular ectasia (arrow 4), hyalinized collagen (arrow 5) and loss of skin adnexa are seen in the dermis. Infiltration by neoplasm was ruled out.
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A punch-biopsy was performed, pathological changes in the skin consistent with radiodermatitis were observed and carcinoma in the involved skin was ruled out ( Figure 2).