The Effectiveness of Diclofenac Sodium in the Treatment of Mondor's Disease of the Breast: The Topical Patch Compared to the Oral Capsules

Mondor's Disease: A Rare Cause of Chest Pain in the Emergency Department

Thrombophlebitis of a subcutaneous vein, known as Mondor's disease, is a rare cause of chest pain and can mimic several more life-threatening diseases. Mondor's disease can be caused by trauma, or hypercoagulable states; however, in many cases the etiology is unknown. Mondor's disease is usually self-limited and can be managed conservatively. In this case report, we highlight a 52-year-old male patient who presented to our emergency department with chest pain caused by Mondor's disease mimicking a pulmonary embolism. Although a rare and benign diagnosis, Mondor's disease should be part of the differential diagnosis of chest pain and can be made on the basis of a thorough history and physical examination alone. Recognition of Mondor's disease could reduce costs and risks of further testing for patients presenting with chest pain.

The dorsal skinfold chamber: A valuable model for the in vivo evaluation of topical formulations

In this study, we introduce the mouse dorsal skinfold chamber model as a valuable approach for the in vivo evaluation of topical formulations. For this purpose, dorsal skinfold chambers were implanted into BALB/c mice. Tumor necrosis factor (TNF)-α was administered to the chamber tissue for the local induction of inflammation followed by the application of diclofenac-containing or diclofenac-free (control) gel onto the skin of the chamber backside. Intravital fluorescence microscopy was repetitively performed throughout an observation period of 24 hours to study macromolecular leakage, leucocyte-endothelial cell interactions and microhaemodynamic parameters. In addition, infiltration of the inflamed tissue with different immune cell subtypes was assessed by immunohistochemistry. In a second set of experiments, the effect of dermal application of a diclofenac-containing gel on photochemically induced thrombus formation was analysed. It was observed that macromolecular leakage, numbers of adherent leucocytes and tissue infiltrating myeloperoxidase (MPO)-positive neutrophilic granulocytes and CD68-positive macrophages were significantly reduced in dorsal skinfold chambers treated with diclofenac-containing gel when compared to controls. Moreover, the diclofenac-containing gel exerted an anti-thrombotic activity, as indicated by a significantly prolonged complete vessel occlusion time. These findings demonstrate that the mouse dorsal skinfold chamber represents a valid and versatile tool to evaluate the effects of topical formulations in vivo.

Mondor's Disease after Aesthetic Breast Surgery: A Case Series and Literature Review

Background:

Mondor’s disease of the subcutaneous veins of the breast is an uncommon disorder. The etiology of Mondor’s disease remains unclear. Usually, it is a self-limited disease. This condition has been associated with trauma, surgical biopsies, breast surgery (including silicone breast implant), physical activity, and a manifestation of breast cancer.

Materials and Methods:

This is a retrospective analysis of 652 female patients who underwent aesthetic breast surgery in the last 10 years.

Results:

We found three cases of Mondor’s disease after plastic surgery of the breast (0.46%) and performed an analysis of the clinical aspects and therapeutic measures. The disease onset was a couple of weeks to 2 years after surgery, never within the first 2 weeks after surgery. We did not observe ulceration or breast cancer. Treatment was unnecessary in two patients, whereas hot compresses and nonsteroidal medical drugs were prescribed in one patient. All lesions healed within 2–3 weeks.

Conclusion:

Mondor’s disease is a possible complication after aesthetic breast surgery but often runs a self-limiting course with spontaneous remission. It is important to exclude breast cancer. The patient should be informed that the disease runs a benign and self-limiting course.