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2012 | 7 | 2 | 149-153

Article title

Erysipelas in breast cancer patients after the radical mastectomy


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Erysipelas is a bacterial cellulitis usually associated with Streptococcal infection. It may appear as a complication following mastectomy and radiotherapy for breast cancer. The study involved 17 cases of erysipelas of the upper limbs with a median age of 62 years. Here we described the clinical, therapeutic and evolutionary aspects of erysipelas. Our results indicated that the erysipelas appeared with an average of 9 years after mastectomy and was recurrent in three patients (17.64%). It is associated with obesity in 42% and arterial hypertension in 52.9% of patients with breast cancer after radical mastectomy. Breast cancer patients in advance stages of disease at presentation (T2+ T3) are significantly more subject to erysipelas in comparison to those patients with locoregional stage of disease at presentation (T1), Mann Whitney U-test, (p<0.05). All patients had complete response to antibiotics. The recurrence occurred in 2 patients (11.76%) who underwent radiotherapy with adjuvant tamoxifen and in one patient who underwent chemotherapy and radiotherapy combined. Based on these results it is possible to suggest that patients who received radiotherapy may have an additional risk factor for developing lymphedema and erysipelas










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1 - 4 - 2012
3 - 2 - 2012


  • Institute for Oncology and Radiology of Serbia, 11000, Belgrad, Serbia
  • Institute for Oncology and Radiology of Serbia, 11000, Belgrad, Serbia
  • Institute for Oncology and Radiology of Serbia, 11000, Belgrad, Serbia
  • Institute for Oncology and Radiology of Serbia, 11000, Belgrad, Serbia
  • Institute for Oncology and Radiology of Serbia, 11000, Belgrad, Serbia
  • School of Medicine, University of Kragujevac, Serbia, 34000, Kragujevac


  • [1] Dupuy A, Benchikhi H, Roujeau JC, Bernard P, Vaillant L, Chosidow O, Sassolas B, Guillaume JC, Grob JJ, Bastuji-Garin S. Risk factors for erysipelas of the leg (cellulitis): case-control study. BMJ. 1999 Jun 12;318(7198):1591–1594 http://dx.doi.org/10.1136/bmj.318.7198.1591[Crossref]
  • [2] Masmoudi A, Maaloul I, Turki H, Elloumi Y, Marrekchi S, Bouassida S et al. Erysipelas after breast cancer treatment (26 cases). Dermatol Online J. 2005; 11: 12 [WoS]
  • [3] Krasagakis K, Valachis A, Maniatakis P, Krüger-Krasagakis S, Samonis G, Tosca AD. Analysis of epidemiology, clinical features and management of erysipelas. Int J Dermatol. 2010, 49(9):1012–1017 http://dx.doi.org/10.1111/j.1365-4632.2010.04464.x[WoS][Crossref]
  • [4] Godoy JMP, Silva HS. Prevalence of cellulites and erysipelas in post-mastectomy patients after breast cancer. Arch Med Sci. 2007; 3: 249–251
  • [5] Ben Salah H, Siala W, Maaloul I, Bouzid F, Frikha M, Daoud J. Erysipelas after breast cancer treatment. Tunis Med. 2002; 80: 465–468 [PubMed]
  • [6] Sakorafas GH, Peros G, Cataliotti L, Vlastos G. Lymphedema following axillary lymph node dissection for breast cancer. Surg Oncol. 2006; 15:153–165 http://dx.doi.org/10.1016/j.suronc.2006.11.003[Crossref]
  • [7] Herd-Smith A, Russo A, Muraca MG, Del Turco MR, Cardona G. Prognostic factors for lymphedema after primary treatment of breast carcinoma. Cancer. 2001; 92: 1783–1787 http://dx.doi.org/10.1002/1097-0142(20011001)92:7<1783::AID-CNCR1694>3.0.CO;2-G[Crossref]
  • [8] El Saghir NS, Otrock ZK, Bizri AR, Uwaydah MM, Oghlakian GO. Erysipelas of the upper extremity following locoregional therapy for breast cancer. Breast. 2005; 14: 347–351 http://dx.doi.org/10.1016/j.breast.2005.02.011[Crossref]
  • [9] Vignes S, Dupuy A. Recurrence of lymphedema-associated cellulites (erysipelas) under prophylactic antibiotherapy: a retrospective cohort study. J Eur Acad Dermatol Venereol. 2006; 20: 818–822
  • [10] Leclerc S, Teixeira A, Mahe E, Descamps V, Crickx B, Chosidow O. Recurrent Erysipelas: 47 cases. Dermatology. 2007; 214: 52–57 http://dx.doi.org/10.1159/000096913[WoS][Crossref]
  • [11] Godoy, J.M. P. Azoubel L. M. O., M., Godoy FG. Erysipelas and lymphangitis in patients undergoing lymphedema treatment after breast-cancer therapy. Acta Dermatoven APA, 18,(2), 2009, 63–65
  • [12] Koster JB, Kullberg BJ, van der Meer JW. Recurrent erysipelas despite antibiotic prophylaxis: an analysis from case studies. Neth J Med. 2007; 65:89–94

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