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(Circulation. 2009;120:1842.)
© 2009 American Heart Association, Inc.

Images in Cardiovascular Medicine

Subclavian Artery Occlusion Masquerading as Painful Breast Plaque

David A. Wetter, MD; Marian T. McEvoy, MD; Riyaz Bashir, MD; Verghese Mathew, MD

From the Department of Dermatology (D.A.W., M.T.M.) and the Division of Cardiovascular Diseases (R.B., V.M.), Mayo Clinic, Rochester, Minn.

Reprint requests to Marian T. McEvoy, MD, Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail mcevoy.marian@mayo.edu

An extract of the first 100% of the full text is provided, because this article has no abstract.

A 51-year-old woman had an exquisitely tender lesion on her left breast for 1 year. She denied pain or numbness of the left arm. Her medical history was contributory for long-standing and quiescent Takayasu arteritis. Physical examination demonstrated a reticulated, atrophic plaque with overlying telangiectasias on the left breast (Figure, A); deep palpation of the area elicited severe pain. Upper- and lower-extremity pulses were not palpable. A skin biopsy specimen revealed diffuse proliferation of endothelial cells in the dermis consistent with diffuse dermal angiomatosis, a rare skin condition typically seen in patients with severe vascular occlusive disease. Vascular angiography demonstrated complete occlusion of the left subclavian artery (Figure, B), which was subsequently treated with percutaneous angioplasty and stent placement (Figure, C). The patient reported complete resolution of pain and markedly improved skin findings 1 month after the procedure (Figure, D). This case illustrates an unusual cutaneous manifestation of vascular occlusive disease that may be easily overlooked by an unsuspecting practitioner.¹

View larger version (123K):   Figure. Painful breast plaque secondary to subclavian artery occlusion. A, Telangiectatic plaque of the left breast. Vascular angiograms demonstrated (B) complete occlusion of the left subclavian artery with (C) subsequent revascularization after percutaneous angioplasty and stent placement. D, Follow-up image showed improvement in skin findings after revascularization procedure.

None.

1. Yang H, Ahmed I, Mathew V, Schroeter AL. Diffuse dermal angiomatosis of the breast. Arch Dermatol. 2006; 142: 343–347.[Abstract/Free Full Text]