Premium
Five patients with melanosis of the nipple and areola clinically mimicking melanoma
Author(s) -
Isbary G.,
CorasStepanek B.,
DyallSmith D.,
Guther S.,
Tillmann A.,
Stolz W.
Publication year - 2014
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.12225
Subject(s) - medicine , areola , melanosis , dermatology , melanoma , pigmentation disorder , biopsy , vitiligo , differential diagnosis , surgery , pathology , cancer research
Background Pigmented lesions on the nipple and areola concern patients and physicians as melanoma and pigmented mammary Paget's disease must be considered in the differential diagnoses. There have been only six case reports of melanosis of the nipple and areola in the medical literature yet five cases presented to our department in a 26‐month period. Method Five women aged between 26 and 34 years presented with pigmentation of the areola and/or nipple. Two patients were pregnant and one also had vitiligo. All lesions were solitary, eccentrically located with a sharp but irregular contour, and homogeneous pigmentation. Dermoscopy was performed and reassuring features included light to dark brown cobblestone pigmentation with ring‐like structures and reticulation. Blue‐white veil and irregular centred black dots were not seen. Histology confirmed melanosis of the nipple and areola. Conclusion Melanosis of the nipple and areola is probably significantly underreported in the medical literature and, based on our experience, is likely to be the most common cause of pigmentation at this site. Considering this, benign condition on clinical and dermoscopic features should lead to biopsy rather than excision to confirm the diagnosis. Further reports of the dermoscopic features will help to define this condition further.