STUDY - Technical - New Dacian's Medicine
Peau
d'orange (Orange peel) (Classical / Allopathic Medicine)
Usually,
a late sign of breast cancer, peau d'orange (orange peel
skin) is the edematous thickening and pitting of breast
skin. This slowly developing sign can also occur with
breast or axillary lymph node infection, erysipelas, or
Graves’ disease. Its striking orange peel appearance stems
from lymphatic edema around deepened hair follicles. (See
Recognizing peau d'orange.)
HISTORY:
Ask the patient when she first detected the peau d'orange. Ask if she has noticed lumps, pain, or other breast changes.
Ask the patient about associated signs and symptoms, such as malaise, achiness, and weight loss.
Ask the patient if she's lactating or if she has recently weaned her infant.
Review the patient's medical history, noting especially axillary surgery that might have impaired lymphatic drainage of a breast.
Ask the patient when she first detected the peau d'orange. Ask if she has noticed lumps, pain, or other breast changes.
Ask the patient about associated signs and symptoms, such as malaise, achiness, and weight loss.
Ask the patient if she's lactating or if she has recently weaned her infant.
Review the patient's medical history, noting especially axillary surgery that might have impaired lymphatic drainage of a breast.
PHYSICAL
ASSESSMENT:
Observe the patient's breasts. Estimate the extent of the peau d'orange, and check for erythema.
Assess the nipples for discharge, deviation, retraction, dimpling, and cracking.
Gently palpate the area of peau d'orange, noting warmth or induration. Then palpate the entire breast, noting fixed or mobile lumps, and the axillary lymph nodes, noting enlargement.
Take the patient's vital signs, noting increased temperature.
Observe the patient's breasts. Estimate the extent of the peau d'orange, and check for erythema.
Assess the nipples for discharge, deviation, retraction, dimpling, and cracking.
Gently palpate the area of peau d'orange, noting warmth or induration. Then palpate the entire breast, noting fixed or mobile lumps, and the axillary lymph nodes, noting enlargement.
Take the patient's vital signs, noting increased temperature.
Recognizing
peau d'orange
With peau d'orange, the skin appears to be pitted (as shown). This condition usually indicates late-stage breast cancer.
SPECIAL CONSIDERATIONS:
Because peau d'orange usually signals advanced breast cancer, provides emotional support for the patient. Encourage her to express her fears and concerns.
With peau d'orange, the skin appears to be pitted (as shown). This condition usually indicates late-stage breast cancer.
SPECIAL CONSIDERATIONS:
Because peau d'orange usually signals advanced breast cancer, provides emotional support for the patient. Encourage her to express her fears and concerns.
PATIENT
COUNSELING:
Instruct the patient on what to expect from diagnostic testing, which may include mammography and breast biopsy.
Instruct the patient on what to expect from diagnostic testing, which may include mammography and breast biopsy.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common symptoms,
Edition V, McGraw - Hill, 2002.