Cutaneous ulceration and breast implant compromise after pulse dye laser for radiation-induced telangiectasias

INTRODUCTION Breast cancer is the most common noncutaneous malignancy occurring in women and as such patients are experiencing the sequelae of treatments. Radiation therapy is used in the adjuvant setting for locally advanced breast carcinoma or in patients after total mastectomy. Radiation dermatitis, both acute and chronic, can complicate radiation therapy. Chronic radiation dermatitis presents as isolated or diffuse telangiectasias over the radiated field and may be physically disfiguring and psychologically distressing for patients. These patients may present to dermatologists for treatment with laser and light-based devices. Previously radiated skin has the potential for cutaneous compromise. We report a case of cutaneous ulceration after pulsed dye laser treatment and the potential complications of treating radiated tissue. We also discuss methods for safe treatment of these patients.