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Diffuse dermal angiomatosis of the breast in a young woman

Diffuse dermal angiomatosis of the breast (DDAB) is a variant of diffuse dermal angiomatosis (DDA) affecting females (40 - 60 years old) with macromastia, obesity, smoking, and vasculo-pathic disorders. DDAB is considered a distinct condition within the spectrum of reactive cutaneous angiomatoses.1 A 19-year-old female presented to our in-patient clinic with a 5-year history of vascular lesions on both breasts which tended to ulcerate since about 6 months. Apart from obesity (body-mass-index 42.6) and nicotine abuse (2.5 pack years) her medical history was unremarkable. On examination, she showed hypertrophic breasts with reticulated, in part bizarrely configurated, vascular formations and ulcers (Fig. 1a and 1b).