What Causes Peau D’Orange?

Medically reviewed by Monica Bien, MPA, PA-C on July 11, 2016Written by Elizabeth Connor on July 11, 2016

Overview

If you’ve noticed a dimpling on your skin that’s similar to the texture of an orange rind, you may wonder what it means. This symptom is known as peau d’orange, which is French for “skin of an orange.” It can occur almost anywhere on the skin. It can be associated with the breasts in both men and women.

In addition to peau d’orange, you may notice other symptoms, such as:

  • swelling
  • redness
  • tenderness
  • wounds with black scabs
  • scales or dry flaky skin

Additional symptoms, as well as the location of the peau d’orange, can provide clues about the cause of this symptom.

Causes

Many different conditions can cause peau d’orange.

Breast cancer

Peau d’orange in the breast may be a symptom of inflammatory breast cancer. Inflammatory breast cancer gets its name because rather than forming a tumor, the cancer cells block the lymphatic vessels. This causes fluid to accumulate in the breast. Fluid accumulation in the breast is known as edema, and it can make the breast appear inflamed.

In addition to peau d’orange, other symptoms of inflammatory breast cancer may include:

  • swelling and redness that can cover a third or more of your breast
  • a pink, reddish, purple, or bruised appearance of the skin
  • a rapid increase in breast size
  • sensations of heaviness, burning, pain, or tenderness in the breast
  • an inward-facing nipple
  • swollen lymph nodes under the arm, near the collarbone, or both

Peau d’orange on the breast doesn’t mean you definitely have breast cancer, but it could be a telltale sign. It’s important to see your doctor if you have peau d’orange on your breast.

Lymphedema

Lymphedema is swelling that occurs due to a block in the lymph vessels. If you have primary lymphedema, the blockage occurs spontaneously. If you have secondary lymphedema, various things may cause the blockage, such as:

  • cancer
  • therapy or surgery for malignant diseases
  • infections
  • chronic venous insufficiency
  • birth defects
  • obesity

Regardless of the cause of lymphedema, the fluid that builds up in the lymph vessel can lead to infection. See your doctor if you suspect this condition so that your doctor can determine the underlying cause and begin treatment. Treatment can help reduce your risk of infection and other complications.

Infection

Skin and soft tissue infection can cause peau d’orange. Acinetobacter baumannii, for example, can lead to cellulitis, which is an infection in the skin and the tissues beneath the skin. This can lead to peau d’orange. A. baumannii is also responsible for infections in the bloodstream and urinary tract. It may also cause ventilator-associated pneumonia in people who have been on a ventilator in the hospital.

Cellulite

Cellulite refers to uneven fat deposits immediately below the skin that make the skin appear dimpled and bumpy. Approximately 85 percent of women over the age of 20 have some form of cellulite. Although cellulite can resemble the rind of an orange peel, people rarely refer to it as peau d’orange.

Cellulite is more common in women than in men. It’s also more common in people who are overweight or who have a family history of cellulite.

Swelling of the breast

If your breasts become swollen or enlarged, such as during pregnancy, you may notice peau d’orange on your breasts. This can be benign and occur as a side effect of pregnancy. Pregnant women can develop inflammatory breast cancer, though, so if you notice a peau d’orange appearance you should tell your doctor right away. If peau d’orange in pregnancy is benign, it should resolve after the swelling has resolved.

Diagnosis

When you see your doctor about peau d’orange, they’ll perform a physical exam and they may decide to perform a biopsy of the affected area if they suspect the peau d’orange is due to inflammatory breast cancer. A tissue biopsy is a quick procedure. It’s usually done with local anesthesia in a doctor’s office. Your doctor will then send the tissue sample to a pathology lab for analysis.

Your doctor may recommend a mammogram or a breast MRI. “Mammograms don’t always pick up inflammatory breast cancer, so sometimes they recommend breast MRI,” says Dr. Rajani Katta

Treatment

Your doctor will likely need to treat the underlying cause of your peau d’orange instead of treating the peau d’orange itself. Treatment varies depending on the cause.

Breast cancer

Inflammatory breast cancer treatment, like treatment for other types of breast cancer, will usually include:

  • chemotherapy
  • surgery
  • radiation
  • hormonal therapy
  • targeted therapies

Individual treatment will depend on the stage and type of cancer. Inflammatory breast cancer is very aggressive, so surgery will almost always include a modified radical mastectomy and lymph node dissection. Because the peau d’orange in breast cancer is a symptom of the cancer, it will resolve if the cancer responds to treatment.

Lymphedema

Treatment for lymphedema depends on where it is and the severity of the swelling. Treatment often includes:

  • compression garments
  • exercises
  • massage
  • elevation of the affected area

Infections associated with lymphedema can be treated with antibiotics, but may sometimes require incision and drainage, or surgery.

Infection

If a skin or soft tissue infection is causing it, treating the underlying infection can treat peau d’orange. Treatment will vary depending on the cause of the infection.

Cellulite

You may be able to reduce the appearance of cellulite by:

  • losing weight
  • exercising
  • applying topical creams to the area.
  • massaging the area
  • applying increased heat to the area

Learn more: How to lose leg fat »

Outlook

Peau d’orange has a wide variety of possible causes. If you have peau d’orange in the breast, especially if it develops rapidly, it may be a sign of inflammatory breast cancer.

If you have peau d’orange, especially if it’s on your breast, you should see your doctor right away. An early and accurate diagnosis is key to successful treatment.

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