Erysipelas of the upper extremity following locoregional therapy for breast cancer.
Cellulitis is a well-known complication of lymphedema of the lower extremities. Erysipelas of the upper extremity complicating breast cancer therapy has never been reported in the English-language literature. We describe seven breast cancer patients with erysipelas of the upper extremity. Five had a predisposing injury to the extremity. All patients responded very well to intravenous antibiotics without any sequelae. They had rapid resolution with typical desquamation. No long-term sequelae were seen except for mild increase of lymphedema. Erysipelas should be listed as a rare complication after locoregional therapy for breast cancer. Intravenous penicillin should be used as the initial therapy. Prevention of arm lymphedema and avoidance of any trauma to the arm are important prophylactic measures. Sentinel lymph node biopsy reduces the rate of axillary lymph node dissection and thus should reduce the incidence of lymphedema and erysipelas.
Division of Hematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 113-6044, Beirut, Lebanon. nagi.saghir@aub.edu.lb
Nagi S
NS
El Saghir
Zaher K
ZK
Otrock
Abdul Rahman N
AR
Bizri
Marwan M
MM
Uwaydah
Gerard O
GO
Oghlakian
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001365:Axilla; D001943:Breast Neoplasms / Q000601:surgery*; D004886:Erysipelas / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008209:Lymphedema / Q000209:etiology; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D012008:Recurrence; D034941:Upper Extremity
D000900:Anti-Bacterial Agents; D010406:Penicillins