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May 1973

Verrucose Areolar Hyperpigmentation of Pregnancy

Author Affiliations

Lackland Air Force Base, Tex

Arch Dermatol. 1973;107(5):774. doi:10.1001/archderm.1973.01620200080026

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To the Editor.—  Pigmentation of the nipples secondary to pregnancy is a well-known phenomenon. Recently, we have seen a probable variation of this phenomenon that was manifested by verrucose lesions of the areolae.

Report of a Case  A 24-year-old Mexican-American woman had a 16-month history of bilateral involvement of her areolae, with multiple friable irregular papules measuring from 1 to 3 mm in diameter (Fig 1 and 2). The lesions first appeared during her fifth month of pregnancy, gradually increasing in size and number up to partuition, and have persisted unchanged since then. She stated that the lesions are extremely friable and crumble with vigorous scrubbing but never entirely disappear. Histopathological examination of the lesions revealed a polyploid lesion with massive hyperkeratosis. The basal cell layer was packed with melanin and there were many melanin-laden macrophages in the upper dermis (Fig 3). After having been assured that the lesions were

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