Acta Dermato-Venereologica 98-5CompleteContent | Page 22

QUIZ SECTION Brownish Plaque with Progressive Growth on the Breast: A Quiz Javier ARELLANO 1,2 , María Jose MESA 2 and Yamile CORREDOIRA 2,3 Departments of 1 Dermatology and 3 Pathology, Hospital Clínico San Borja Arriarán, Santa Rosa 1234, Santiago, and 2 Faculty of Medicine, Uni- versity of Chile, Santiago, Chile. E-mail: [email protected] We report here a case of a 60-year-old woman with a his- tory of adequately controlled type 2 diabetes, hypertension and hypothyroidism, on daily treatment with metformin, hydrochlorothiazide and levothyroxine. She presented at the dermatology clinic with a 10-year history of a slowly growing and occasionally painful plaque on her left breast. Physical examination revealed that the patient was an obese, but otherwise healthy, Hispanic woman with a brownish-coloured plaque that measured up to 6 cm in diameter, on her left breast (Fig. 1). Histopathology, punch biopsy and subsequent complete excision of the plaque de- monstrated a spindle-cell proliferation, with myofibroblasts with no atypia (Fig. 2). What is your diagnosis? See next page for answer. Fig. 1. A brownish plaque on the left breast. Fig. 2. (a) Haematoxylin and eosin (H&E) 25×. Band-like, ill- defined spindle-cell proliferation in the reticular dermis. (b) H&E 100×. Dermal myofibroblastic proliferation in fascicles running parallel to the epidermal surface. (c) H&E 400×. Uniform-spindled myofibroblasts with no nuclear atypia or mitoses. 540 doi: 10.2340/00015555-2899 Acta Derm Venereol 2018; 98: 540–541 This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2018 Acta Dermato-Venereologica.