Other reported ways of discriminating between
sclerosing lymohangitis and Mondor’s disease include
collection of yellow aspirate from the lesion
(which supports the lymphatic origin of the disease),
histological examination of the excised lesion, immunohistochemical
CD31 and CD 34 marker analysis,
and electron microscopic examination (2). Such extensive
diagnostic work-up is not necessary because
confined and painless cases of Mondor’s disease that
could be misdiagnosed as sclerosing lymphangitis do
not require treatment and also resolve spontaneously.
If the condition is painful or extensive it is certainly
thrombophlebitis, and treatment with analgesics, local
anesthetic injection, local heparin, or antibiotics
(in cases of celulitis) may be indicated (4). In cases
that are very painful and do not resolve (around 8%
of cases) thrombectomy or resection of the affected
vein can been undertaken (4).
It is important to reassure the patients that sclerosing
lymphangitis is a self-limiting disease that
resolves spontaneously within several weeks if they
restrain from vigorous sexual activity until the condition
subsides, but that it may recur after sexual activity
has been resumed. No treatment is required.
Nonsteroidal anti-inflammatory drugs (NSAID) have
been recommended but without proven benefit. In
recurring cases surgery may be undertaken with extirpation
of the affected vessel (2).