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July 2003

Accessory Nipple Looks Like Dermatofibroma in Dermoscopy

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Copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2003

Arch Dermatol. 2003;139(7):948-949. doi:10.1001/archderm.139.7.948-a

Accurate classification of skin tumors concerning their benign or malignant diagnosis is increasingly demanded. Typical patterns for melanocytic and nonmelanocytic lesions are well established for the clinical, and particularly for the dermoscopic (dermatoscopic, epiluminescence microscopic), examination.1,2 The clinical diagnosis of dermatofibromas and accessory nipples (polythelia) is normally not difficult.3 Accessory nipples are more prevalent in males than in females, with the typical location between the breast and groin.3 But in some doubtful cases the additional use of dermoscopy can be helpful. On dermoscopic examination (Heine Dermatophot), dermatofibroma as a common benign tumor has the typical central white scarlike patch with a delicate pigmented network at the periphery (Figure 1).4,5 Dermoscopy also reveals this pattern in accessory nipples (Figure 2). The delicate network at the periphery of both lesions can be explained by an epidermal hyperplasia on histopathologic examination and represents the areola of the accessory nipple. To our knowledge, this dermatofibroma-like pattern has not been described for accessory nipple in the dermoscopic literature and should be included in the list of nonmelanocytic tumors of the skin.