A 34-year-old woman for whom chemotherapy had failed to cure acute lymphocytic leukemia received an allogeneic hematopoietic stem-cell transplant (HSCT) that was complicated by biopsy-proven, acute, generalized, cutaneous graft-vs-host disease (GVHD) beginning 39 days after transplant. She was referred for an obstetric and gynecologic evaluation on day 58 for nipple cracking and dryness of 3 weeks' duration. She denied breastfeeding, exposure of the nipples to any topical or mechanical irritants, or sun exposure. Her generalized skin eruption had resolved by this time.
Brunengraber LN, Turner M, Lee CR, Stratton P. Bilateral Areolar Lesions in a Patient With Acute Cutaneous Graft-vs-Host Disease. Arch Dermatol. 2011;147(4):509-511. doi:10.1001/archdermatol.2011.75