Malignant melanoma in accessory nipple in a male

Dermoscopy of accessory nipples in authors' own study

Introduction

The accessory nipple (AN) is characterised by its network-like structures, which may suggest the diagnosis of a melanocytic lesion. The knowledge about additional dermoscopic features of AN may greatly minimise the risk of unnecessary surgical excisions.

Aim

To analyse and present different clinical and dermoscopic forms, in which the AN may appear.

Material and methods

Ninety AN with dermoscopic features were evaluated in the study, detected in 14 patients between the years 2008 and 2014.

Results

The most common dermoscopic features of the AN were central, scar-like areas (15/19) and peripheral network-like structures (12/19). A number of cleft-like appearances (8/19) and central network-like structures (7/19) had also been observed. Moreover, among the dermoscopic features, white cobblestone-like structures (7/19), a central round dimpling with a plug (6/19) and fisheye-like structures resembling comedo-like openings (9/19) have all also been noted. There is a statistical significance in the occurrence of white cobblestone-like structures with central network-like structures (Fisher's exact test p = 0.0449). The presence of peripheral network-like structures with the occurrence of central scar-like areas was statistically highly significant (p = 0.0091). The central round dimpling was never observed alongside any central network-like structures in any of the lesions (p = 0.0436).

Conclusions

Accessory nipples are most commonly characterised by the occurrence of a peripheral network-like structure accompanied by the presence of a scar-like area.