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March 2013

Unilateral Hyperpigmented Lesion of the Breast in a Young Woman—Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD

JAMA Dermatol. 2013;149(3):358-363. doi:10.1001/archderm.149.3.358-c

A 33-year-old woman who was in her second month of pregnancy presented with a pigmented lesion on her right breast, which had been expanding slowly for the previous 7 months. The patient reported having been diagnosed as having vitiligo 15 years previously, and it was treated with topical corticosteroids. Clinical examination revealed a well-demarcated, dark, hyperpigmented lesion affecting the right areola and the right nipple, without infiltration or epidermal changes (Figure 1). The left areola and nipple had no cutaneous lesions. Dermoscopy revealed a reticular pattern (Figure 2). Laboratory test results (full blood cell count, basic biochemical analyses, thyroid function, and random cortisol level) were normal. Three biopsy specimens of the areola and the nipple were obtained (Figure 3).

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