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Image Number 1404 (Paget's disease of nipple and areola)


Diagnosis: Paget's disease of nipple and areola

Site: Breast

Sex: F

Age: 50


Description: Red scaly plaque.

Submitted by: Nameer Al-Sudany

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Differential Diagnosis

History: Paget’s disease of the nipple (apocrine ductal carcinoma)is a well-defined red scaly plaque spreads slowly over and around the nipple. It is caused by the invasion of the epidermis by cells from an underlying intraductal carcinoma of the breast (Paget cells). The condition is sharply marginated and unilateral. A skin biopsy should be carried out first and if the diagnosis is confirmed mastectomy will be necessary. Be alert to the possibility of Paget’s disease if a red plaque affects only one nipple, and alters its normal architecture as in the presented case which presented with more than one year history of a unilateral well-demarcated pruritic eczematous plaque involving one breast mainly the nipple and peri-nipple areolar area with complete destruction of the nipple.Skin biopsy showed numerous Paget's cells invading the epidermis.

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