'Eczematous' dermatitis of the nipple: clinical and histopathological differential diagnosis of Paget disease

The nipple can be affected by many malignant and benign entities. A wide variety of diseases including Paget disease, atopic dermatitis and nipple candidiasis can cause eczema-like changes in the nipple. In cases of diagnostic uncertainty, tissue sampling may be indicated. A true eczematous lesion, such as atopic dermatitis, typically shows a spongiotic dermatitis pattern. Paget disease, on the other hand, presents with infiltration of the nipple epidermis by neoplastic cells. The presence of atypical cells scattered in the epidermis in a pagetoid pattern opens up a histopathological differential diagnosis encompassing squamous cell carcinoma in situ and malignant melanoma, among others. Immunohistochemistry is commonly used to render a diagnosis. The objective of this article is to discuss Paget disease and highlight relevant clinical and histopathological differential diagnoses.

Brief report: Areolar melanosis in a girl with precocious puberty

We report a case of melanosis of the areola in a 7-year-old girl with early thelarche. Areolar melanosis is a rare condition previously only described in women over 25 years of age, often in the setting of pregnancy. This case supports a theory that hyperpigmentation may be associated with increased sensitivity to hormonal stimulation in areas with greater populations of melanocytes.

Unilateral hyperpigmented lesion of the breast

Muco‐cutaneous melanosis is a benign entity with no progression. Although, dermoscopic features may help to differentiate melanosis from malignant pigmented diseases, histopathology remains crucial for the confirming of melanosis of the nipple and areola. Herein, we represent a new case of melanosis of the areola and we describe its clinico‐pathological aspects.

Muco‐cutaneous melanosis is a benign entity with no progression. Although, dermoscopic features may help to differentiate melanosis from malignant pigmented diseases, histopathology remains crucial for the confirming of melanosis of the nipple and areola. Herein, we represent a new case of melanosis of the areola and we describe its clinico‐pathological aspects.