A 10-year-old white boy was referred to the pediatric outpatient department in Belgium in winter with progressive swelling and red discoloration of the right areola that had developed over a few months. No fever or other systemic symptoms were reported. There was no known history of a tick or insect bite, and he had no other recent or concomitant dermatological manifestations. He did not experience local tenderness or pruritus.
Inspection of the right areola revealed a sharply demarcated violaceous nodule with a diameter of 2.5 cm with localized swelling (Figure 1). The lesion was neither tender nor warm. Regional lymphadenopathy was unremarkable. Ultrasound showed a very discrete, unilateral increase in retroareolar glandular tissue without evidence for an added mass.
Van Nieuwenhove E, Toelen J, Casteels K. A Swollen, Red Areola in a Young Boy. JAMA Pediatr. 2016;170(3):289-290. doi:10.1001/jamapediatrics.2015.2010