[A case of « peau d'orange » in the absence of cancer]

A 57-year old female patient initially consulted a gynecologist for a cutaneous lesion on her left breast present since 6 weeks. The gynecologist described a plaque-like lesion in the sense of « peau d'orange ». Imaging and a biopsy did not reveal evidence for a malignancy. When she presented in our « walk-in » outpatient clinic for a second opinion, a borreliosis was suspected based on the clinical appearance of the lesion. This hypothesis was confirmed by the -re-evaluation of the skin biopsy by a dermatopathologist and -further substantiated by positive serology. Thus, oral doxycycline (2 x 100 mg/day) for 28 days was prescribed as treatment, resulting in resolution of the lesion. We wish to encourage colleagues to contact a dermatologist for any unclear pathology of the skin and to send skin biopsies to a dermatopathologist, particularly if inflammatory or infectious diseases are suspected.