Acta Dermatoven APA Vol 18, 2009, No 2 63 C l i n i c a l s t u d y Erysipelas and lymphangitis after breast-cancer therapy Erysipelas and lymphangitis in patients undergoing lymphedema treatment after breast-cancer therapy J. M. Pereira de Godoy, L. M. O. Azoubel, M. de Fátima Guerreiro Godoy Aim: The aim of this study was to evaluate the prevalence of erysipelas and lymphangitis in a group of patients under treatment for lymphedema after breast-cancer therapy. Methods: A random observational prospective study of the incidences of lymphangitis and erysipelas was performed for 66 patients with arm lymphedema after breast-cancer treatment. The study was carried out between March 2006 and December 2007 at the Godoy Clinic in São José do Rio Preto, Brazil. The clinical evaluation of the participants was performed weekly before the start of treatment, with patients being required to immediately report any complications to the attending service. Results: The mean time of follow-up of the patients between their treatment for breast cancer and the start of this study was 12.3 months, and three complications (4.5%) occurred; two cases of lymphan- gitis were reported after insect bites and one case of erysipelas after a hand injury, with repeat epi- sodes reported by all three patients. Conclusion: In spite of prophylactic advice regarding lymphangitis and erysipelas during treatment for lymphedema after breast-cancer therapy, patients are subject to complications; however, this in itself does not justify the use of prophylactic antibiotic therapy. Introduction In Brazil, breast cancer is expected to affect 49,400 individuals in 2008. Despite the high incidence of this type of cancer, the survival of women treated in the initial stages of the disease has been increasing (1). In Europe, the cumulative survival is 91% at 1 year and 65% at 5 years; in the United States it is 96.8% at 1 year (2). The treatment of cancer varies by stage. The surgi- cal procedures, apart from extirpation of the tumor, may also include resection of axillary lymph nodes. Therapy can involve surgery, chemotherapy, radiotherapy, and hormone therapy (3). One of the complications of the treatment for breast cancer is lymphedema, with a re- gional prevalence of around 32.5% (4). Erysipelas is a frequent cause of skin infection, usu- ally involving beta-hemolytic streptococcus, which com- monly causes edema (5). This disease has been associ- ated with edema of both upper lower and limbs (6–9). The sequelae that affect patients after mastectomies require multidisciplinary care for their prevention and lymphedema, erysipelas, lymphangitis, breast cancer K E Y WORDS A B S T R A C T 2_09_d.pmd 7/6/2009, 8:05 AM 63