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July 21, 2008

Eroded Patch on the Nipple of a 57-Year-Old Woman—Quiz Case

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Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2008

Arch Dermatol. 2008;144(7):933-938. doi:10.1001/archderm.144.7.933-a

A 57-year-old white woman presented with a 2-year history of an intermittently bleeding growth of her left nipple. She had no history of internal malignant disease. Findings from physical examination revealed a 1.2 × 1.1-cm eroded patch confined to approximately 60% of the left nipple (Figure 1). There was no lymphadenopathy of the regional lymph nodes. Following an initial diagnostic biopsy, the lesion was completely excised with 2 stages of Mohs micrographic surgery, and the remaining portions of the nipple were reconstructed with a complex wound repair. Sections from the excisional specimen are seen in Figure 2 and Figure 3. An immunoperoxidase stain for smooth muscle actin was also performed on this tissue.

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