Unilateral Breast Skin Changes in Patient With Hidradenitis Suppurativa: Malignancy Versus Lymphedema

Hidradenitis suppurativa (HS) is an inflammatory skin disorder typically affecting the groin, inframammary folds, and axillae. HS is characterized by the development of boils, abscesses, fistulas, and sinus tracts. Due to the inflammatory destruction of lymph vessels, patients with long-standing HS may develop lymphedema. Most commonly reported in the literature is lymphedema involvement of the genital and anal regions. In this case report, we describe unilateral breast skin changes in a patient with HS. The patient was extensively worked up for inflammatory breast cancer, and eventually underwent stereotactic biopsies. Subsequently, these biopsies were consistent with lymphedema due to her chronic HS. Although rare, there is a paucity of literature describing breast lymphedema associated with HS. As breast lymphedema due to HS may mimic inflammatory breast cancer, it is important for providers to firstly rule out malignancy and place lymphedema high on the differential when examining and treating these patients.