Lupus mastitis (LM) is an uncommon and rare clinical presentation of systemic lupus erythematosus (SLE) which is described as benign inflammation of the deep subcutaneous adipose tissue of the breast. While a vast majority of patients present with systemic or discoid lupus (DL), LM can be the initial finding. When the breast is affected, the term LM is used. The etiology is not clearly known. Skin manifestations of LM are as follows: epidermal atrophy, hyperkeratosis, lipoatrophy, erythema, hypertrichosis, ulceration and if left untreated - even fistulization, atrophy with scarring and retraction may develop. LM has a chronic course with aggravation and remission. Clinically close follow-up is required as flare ups can emerge in a different area. Antibodies can present, but are not required for the diagnosis. Breast lupus panniculitis are usually solid and can mimic malignancies. If skin changes are evident, it may be difficult to distinguish LP from inflammatory breast cancer. While hydroxychloroquine is the first line treatment option for LM, systemic steroids and cyclophosphamide may also be used. Deep localisation of the lesions mostly require tissue biopsy to determine whether a neoplasm exists or not. In patients diagnosed with SLE or DL, aggressive surgical interventions can trigger exacerbation.
Last date updated on May, 2021