A Clinical Study of Skin Diseases on the Nipple and Areola

Lee, Sook Kyung; Jeong, Yun; Choi, Joon Hee

Abstract

BACKGROUND: Nipple and areola diseases of the breast cause cosmetic, sexual and functional problems, and these problems are important to most patients, so awareness of these disease entities is invaluable. Still, there has been insufficient clinical investigation of these conditions.
OBJECTIVE
This study was performed to investigate the epidemiological aspects of nipple and areola diseases that were confirmed by biopsies, and we wanted to highlight the clinical features of dermatoses of the nipple and areola. These disease features were then compared between the patients who visited the Departments of Dermatology and General Surgery.
METHODS
We retrospectively reviewed the data of 80 patients with nipple and areola lesions and these lesions were confirmed by biopsy at Maryknoll Hospital between March 1989 and August 2007. 37 patients visited the Department of Dermatology and 43 patients visited the Department of General Surgery.
RESULTS
The ratio of males to females was 6:74. The ratio of the males to females seen at the Department of Dermatology was 6:31. In contrast, that of the patients seen at the Department of General Surgery was 0:43. The most frequent nipple and areola skin diseases were fibroadenoma, intraductal papilloma, accessory breast and nipple eczema in the decreasing order of frequency. The most frequent nipple and areola skin diseases seen at the Department of Dermatology were nipple eczema, soft fibroma, hyperkeratosis of the nipple and areola, Paget's disease and invasive ductal carcinoma in the decreasing order of frequency. In contrast, the most frequent nipple and areola skin diseases seen at the Department of General Surgery were fibroadenoma, intraductal papilloma, accessory breast, phyllodes tumor and subareolar abscess. Of the 80 cases, 49 had papules or nodules, 15 had patches or plaques, 10 had vesicles, erosions or ulcers and 6 had nipple discharge. Of the 37 cases seen at the Department of Dermatology, 15 had patches or plaques, 14 had papules or nodules and 8 had vesicles, erosions or ulcers. In contrast, of the 43 cases seen at the Department of General Surgery, 35 had papules or nodules, 6 had bloody or serous nipple discharge, and 2 had vesicles, erosions or ulcers.
CONCLUSION
We retrospectively studied 80 cases of nipple and areola skin diseases. This study suggests that various conditions, including dysembryoplasia, inflammatory dermatoses, hyperkeratoses and neoplasm, can affect the nipple and areola and show different characteristics according to the Hospital Department they are seen at. The patients with symptoms of patches or plaques tend to visit the Department of Dermatology. In contrast, patients with symptoms of papules or nodules tend to visit the Department of General Surgery. Further investigation with a large group of patients is necessary to better understand the epidemiology of nipple and areola skin diseases.