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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of an 83-year-old woman who consulted for vesicular lesions on the right arm&#46; The patient&#39;s history included right breast carcinoma&#44; treated with radical mastectomy and lymphadenectomy 17 years ago&#44; with chronic secondary lymphedema&#46; The patient reported that these lesions appeared 2 months ago&#44; were asymptomatic and progressed with flare-ups&#44; which spontaneously ceased in 5&#8211;7 days&#46; The physical examination showed translucent vesicles on skin of normal appearance &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41;&#46; A skin biopsy revealed thin-walled dilated vessels in the papillary dermis&#44; which were formed by flattened cells with spaced nuclei&#46; These structures were positive for the D2-40 immunohistochemical technique &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>b&#41;&#44; confirming the diagnosis of lymphangiectasia&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Acquired lymphangiectasia is the dilation of superficial lymphatic vessels&#44; which can be observed in a wide variety of processes where the lymphatic drainage is impeded&#44; such as in the context of axillary lymphadenectomy or mastectomy due to breast cancer&#44; radiation therapy&#44; hepatic cirrhosis&#44; keloids and scleroderma&#46; This condition manifests clinically as translucent vesicles over an area with previous chronic lymphedema&#46; At the histopathological level&#44; the characteristic feature is the presence of dilated vascular spaces in the papillary dermis&#44; unlike the lymphatic malformations that arise in the deep dermis&#44; with flattened lymphatic endothelial cells&#44; which is verified by the positivity for lymphatic endothelium markers such as D2-40&#46; The prognosis for this condition is favorable&#59; however&#44; recurrence is common&#44; with a tendency towards chronicity&#46;</p></span>"
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Medicine in Images
DOI: 10.1016/j.rceng.2018.08.005
Lymphangiectases on chronic lymphedema following breast cancer treatment
Linfangiectasias sobre linfedema crónico tras tratamiento de cáncer de mama
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L. Vergara de la Campa
Corresponding author
laura.vergara.de.la.campa@gmail.com

Corresponding author.
, E.R. Martínez Lorenzo, E. Molina Figuera
Servicio de Dermatología y Venereología, Complejo Hospitalario de Toledo, Hospital Virgen del Valle, Toledo, Spain

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