Figure 4.

Responses to methylprednisolone for IGM treatment, including skin redness, abscess, and sinus. Patient ID 82, a 33-year-old woman with right IGM after antibiotic treatment at another hospital sought treatment at our clinic. Mastitis involved nearly the whole breast, with a centrally located skin ulcer and fistula (day 0). Surgery with wide excision did not achieve an acceptable cosmetic outcome. The fistula was completely closed after a month of treatment with methylprednisolone (day 35). Patient ID 145, a centrally located lesion with skin redness and edema was present (day 0). The lesion responded well (day 19), but relapsed during steroid withdrawal (day 34), and 20 mg of methylprednisolone was re-administered. At the same time, fine needle aspiration was applied for abscess drainage. Pigmentation and ultrasound detectable lesions were left. Patient ID 8, a 33-year-old woman with left IGM received repeated abscess incision drainage previously in another hospital (day 0). An excellent outcome was achieved by methylprednisolone treatment (day 36), with complete regression as shown by both PE and US. Only skin scars remained (day 324). IGM, idiopathic granulomatous mastitis; PE, physical examination; US, ultrasound.