Sir James Paget described Paget's disease of nipple and areola in 1874. The disease usually presents as well demarcated, erythematous, exudative lesion, starting on the nipple and spreading onto the adjacent areola. As the disease progresses, it leads to ulceration and destruction of the nipple. The commonest symptoms inculde; a bloody nipple discharge (40%), pain (30%) and pruritus (15%). Paget's disease is almost invariably associated with a ductal carcinoma. The differential diagnosis includes chronic eczema, intraduct papilloma, malignant melanoma, Bowen's disease and duct ectasia.