# Granulomatous Mastitis-Related Large Skin Defect in a Patient With Ulcerative Colitis on Mesalazine Therapy

## TL;DR

A woman with ulcerative colitis developed a large skin defect from granulomatous mastitis while on mesalazine therapy and was successfully treated with a specific surgical graft.

## Contribution

Highlights a possible link between mesalazine therapy and large skin defects in granulomatous mastitis and suggests LDMC flap grafting as a feasible treatment.

## Key findings

- Mesalazine therapy may correlate with large skin defect formation in granulomatous mastitis.
- Latissimus dorsi musculocutaneous flap grafting effectively repaired the skin defect with good cosmetic outcomes.
- The patient remained complication-free and well for over two years post-surgery.

## Abstract

A 30-year-old woman with ulcerative colitis on mesalazine therapy developed a breast mass seven months after her first child delivery. Breast massage to the affected breast and drainage of the abscess cavity only resulted in skin necrosis just above the breast mass followed by skin defect formation larger than 10cm in size. A pathological study of the exposed breast tissue led to the diagnosis of granulomatous mastitis (GM). Due to the shrunken but still large skin defect after successful steroid therapy, the patient underwent latissimus dorsi musculocutaneous (LDMC) flap grafting in order to get both better cosmetic outcomes and a shorter treatment period. The patient was discharged without any complications on the eighth day after the operation and has been well with excellent cosmetic outcomes while taking care of her child for 31 months. In conclusion, mesalazine therapy might correlate with this type of large skin defect formation in GM. Breast surgeons should note that LDMC flap grafting can be a feasible therapeutic option to cover large skin defects even in GM patients.