Abstract | INTRODUCTION: PRESENTATION OF CASE: We report the case of a 72-year-old woman with a small breast cancer. She was started on pre-operative letrozole (2.5mg/d) whilst awaiting surgery. Ten days later she presented with burning pain and purpuric skin lesions which progressed to extensive ischaemic superficial necrosis of the lower limb skin, resolving over 3-4 months after local and systemic steroids. Histologically, it showed leucocytoclasis with evidence of eosinophilia consistent with a diagnosis of cutaneous leukocytoclastic small vessel vasculitis. DISCUSSION: The initial clinical presentation was severe burning pain around the ankles and a spreading violaceous rash. Letrozole was stopped. Wide local excision ( lumpectomy) and sentinel node biopsy were postponed because of the accompanying pneumonitis and gastrointestinal upset, and were carried out 3.5 months later. Fortunately, the tumour size did not increase, but appeared to reduce, and axillary lymph nodes remained negative, i.e., this patient's cancer outcome does not seem to have been jeopardized. CONCLUSION:
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Authors | Pirunthan Pathmarajah, Karishma Shah, Kathy Taghipour, Su Ramachandra, Mangesh A Thorat, Ziaullah Chaudhry, Vivek Patkar, Francesca Peters, Thomas Connor, Emma Spurrell, Jeffrey S Tobias, Jayant S Vaidya |
Journal | International journal of surgery case reports
(Int J Surg Case Rep)
Vol. 16
Pg. 77-80
( 2015)
ISSN: 2210-2612 [Print] Netherlands |
PMID | 26432999
(Publication Type: Journal Article)
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Copyright | Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved. |