双侧乳头乳晕角化过度症一例

临床资料患者,女,22岁。因双侧乳头乳晕色素加深伴皮肤肥厚5年,于2012年2月3日就诊。5年前患者双侧乳头乳晕无明显诱因出现色素加深伴皮肤肥厚,后表面出现黑褐色颗粒,皮损面积渐扩大,偶有瘙痒,未予治疗。患者既往无外伤史,无其他皮肤病     

乳头乳晕角化过度症1例

患者女,35岁。双侧乳头乳晕变黑10余年,增生1年。患者10余年前妊娠期间发现其乳头、乳晕颜色较深,未引起重视,随着年龄增长,颜色缓慢加深,1年前无明显诱因乳头乳晕出现增生物,渐增多,月经期较明显。自发病来双侧乳头乳晕无不适感,为求进一步诊治,于年月日来我院就诊。既往体健,无鱼鳞病、黑棘皮病、慢性湿疹等皮肤病。家族中无类似病史。体格检查:一般情况良好,心、肺、腹正常。皮肤科检查:双侧乳头、乳晕密集分布菜花状增生物,呈暗褐色,质软,乳晕范围扩大,边界清晰,无鳞屑及渗出物,乳头无溢液及异味(图1A)。     

乳头乳晕角化过度症

正患者女,25岁。主诉:右侧乳头、乳晕皮肤粗糙变黑1年余。现病史:患者于1年余前妊娠时发现右侧乳头及乳晕皮肤表面粗糙且颜色较前加深,无明显自觉症状,未予治疗。后右侧乳头及乳晕皮肤表面粗糙逐渐加重,颜色变为黑色,遂于2018年2月26日来我院皮肤科就诊。既往史、个人史及家族史:患者平时身体健康,否认有传染病、内分泌及恶性肿瘤疾病病史。患者23岁结婚,月经正常,孕1产1。家族中无类似疾病患者。体格检查:一般情况好,各系统检查均正常。皮肤科检查:右侧乳头及乳晕皮肤呈黑色,皮肤表面粗糙,呈天鹅绒状,皮纹加深、加宽,边界清楚(图1)。     

乳头乳晕过度角化症1例

患者女,25岁,因乳头,乳晕暗褐色斑及斑块半年,于2004年5月10日来我院就诊。半年前患者双侧乳头,乳晕出现鸡蛋大暗褐色斑及斑块,有轻度瘙痒,数天后双下肢出现多角形鳞屑。患者自出生后皮肤较干燥,粗糙,冬重复轻,家庭成员中无类似疾病患者。     

乳头乳晕过度角化症1例

患者女,28岁。乳头乳晕部出现粟粒大小褐色丘疹,渐增多4年。皮损组织病理示:表皮呈乳头瘤样增生,表皮突延长,诊断为乳头乳晕过角化症,给予患者维甲酸类药物外用治疗,目前仍在随访中。     

乳头乳晕角化过度症1例

患者女,25岁。双侧乳头、乳晕呈棕色色素加深伴皮肤肥厚10余年。皮肤科检查:双侧乳头乳晕对称性皮肤色素加深呈暗褐色,乳晕范围扩大,直径5～6cm,边界清楚,皮肤明显增生肥厚,呈疣状突起,沟纹加深加宽,乳头无溢液。组织病理示表皮呈乳头瘤样增生,棘层肥厚,有角质栓塞,基底细胞色素增多。诊断:乳头乳晕角化过度症。     

痣样乳头乳晕角化过度症一例

患者女,34岁,因双侧乳头乳晕疣状增生性斑块3年就诊.3年前无明显诱因下,乳头乳晕出现淡褐色疣状丘疹,质软,偶痒,逐渐增大增多,界清,未用药物治疗.既往无湿疹,鱼鳞病等病史,家族史无类似患者,发病以来精神,饮食,睡眠均正常.     

乳头乳晕过度角化病1例

患者女,46岁.因双侧乳头、乳晕黑褐色变1周,于2010年12月8日就诊.患者于1周前无明显原因出现双侧乳头、乳晕黑褐色色素沉着,伴患处轻度胀痛,无破溃,无渗液.精神,食欲正常,月经周期无异常. 体格检查:各系统检查无异常,全身浅表淋巴结未触及增大.皮肤科检查:双侧乳头,乳晕大小对称,黑褐色色素沉着,疣状增厚,边界清,对称分布(图1A),无破溃,无压痛.     

乳头乳晕角化过度症伴黑棘皮病1例

患儿男,14岁,4年前因发热1个月余在当地医院住院治疗,经血常规检查发现异形淋巴细胞达0.14。在当地血液病研究所诊断为“左颈部淋巴结增大及免疫功能低下”。治疗1个月后（具体用药不详）,体温始终维持在37℃左右,3年后双乳晕变黑,随后双侧腋下皮肤亦变黑。2003年8月来我院就诊。     

痣样乳头乳晕角化过度症四例

目的 报道4例痣样乳头乳晕角化过度症.方法 收集和分析4例痣样乳头乳晕角化过度症患者的临床资料和组织病理学资料.结果 4例患者中,女3例,男1例,平均年龄32岁,平均病程4.5年,均表现为乳头和(或)乳晕角化过度和疣状增生.组织病理检查:表皮角化过度,乳头瘤样增生,皮突延长.结论 痣样乳头乳晕角化过度症是乳头乳晕角化过度症的一种亚型,临床较为少见,好发于年轻女性,临床和组织学都有一定特点.     

Hyperkeratosis of the Nipple: Report of Two Cases

Hyperkeratosis of the nipple and areola is a rare condition; its characteristic properties are verrucous thickening and brownish discoloration of the nipples and areola. The nevoid form of the disease is extremely rare, usually seen in women in the second or third decade of life. The nipple is seldom affected alone. We report two cases of the nevoid form of hyperkeratosis of the nipple. In both female patients, lesions developed after puberty and were confined to both nipples alone. One of the patients' lesions became darker and more verrucous during pregnancy, making breast feeding impossible.     

Diseases of the male nipple and areola

The male nipple‐areola‐complex (NAC) is a residual organ without physiologic functions in the male. It possesses similar hormone sensitivity and sexual sensitivity as the female organ. The location of the NAC on the chest wall with respect to other surface features is relevant for the male appearance. All known disseminated skin diseases may involve the nipple and areola. A number of specific localized diseases have been described in the literature, such as mammillary eczema, demodicidosis, lymphadenosis cutis benigna, nevoid hyperkeratosis, and thelalgia. Special attention is required if nipple discharge is observed. Areolar sebaceous hyperplasia and nearly all kinds of benign cutaneous tumors occur on the nipple and areola. Malignant tumors such as basal cell carcinoma, melanoma, Paget disease and other forms of breast cancer may also be found. In addition, aberrant mammary tissue may occur with a broad clinical spectrum, while absence of the nipple is an unusual observation and occurs in rare syndromes. The association of aberrant mammary tissue with urinary tract malformations has not been confirmed.     

Hyperkeratosis of nipple and areola

Hyperkeratosis of the nipple and areola is a rare condition that may occur in association with various forms of ichthyosis or as the result of extension of an epidermal nevus. The nevoid form is extremely rare and appears most commonly in women in their second or third decade of life. It is characterized by verrucous thickening and brownish discoloration of both nipples and areolae. Thirteen cases of this type have been reported. We are describing two additional cases to bring the total to 15 instances.     

Hyperkeratosis of the nipple and areola

Hyperkeratosis of the nipple and areola is a rare condition. We report two cases of hyperkeratosis of the nipple and areola occurring in men with no underlying endocrinopathy or synthetic estrogenic drug therapy. Both patients demonstrated prompt resolution of the hyperkeratosis of the nipples with a keratolytic gel. Because our cases were not associated with ichthyosis or epidermal nevus, they best fit into the category of nevoid hyperkeratosis of the nipples.     

Idiopathic calcinosis of the areola of the nipple

Idiopathic calcinosis cutis involving the breast is a rare condition. Previously reported cases were detected by mammography without specific cutaneous findings. We report a case of idiopathic calcinosis of the areola of the nipple in a 32-year-old Korean woman that has unique clinical features resembling scrotal calcinosis.     

Painful nipple hyperkeratosis secondary to vemurafenib

Vemurafenib is a selected BRAF kinase inhibitor approved for treating metastatic or unresectable melanoma, which has numerous cutaneous side effects unfortunately, including three previously reported cases of asymptomatic areola and/or nipple hyperkeratosis. We present the first case of painful bilateral nipple hyperkeratosis secondary to vemurafenib in an 84‐year‐old woman. She was successfully treated with tretinoin 0.05% cream that allowed her to comfortably continue treatment. With increased awareness of this condition, we found a second case of asymptomatic nipple hyperkeratosis secondary to vemurafenib in our clinic. As this medication gains acceptance for treatment of metastatic melanoma, it is imperative that dermatologists are aware of this potentially uncomfortable side effect that can result in decreased compliance and impaired quality of life.     

Nevoid hyperkeratosis of male breast: Successful treatment with minocycline

Nevoid hyperkeratosis of the nipple and/or areola (NHNA) is an uncommon disease with no definite etiology. NHNA of the male breast is rare in clinical practice. Despite being a benign disease, it is distressing for patients and therapeutically challenging for clinicians. We report a male patient with NHNA who responded favorably to minocycline treatment.     

Nevoid hyperkeratosis of the nipple and areola: treatment with topical retinoic acid

Nevoid hyperkeratosis of the nipple and areola is a rare dermatosis with unknown etiology, (Perez-Izquierdo JM, Vilata JJ, Sanchez JL, et al. Retinoic acid treatment of nipple hyperkeratosis. Arch Dermatol 1990;126:687-688). Only 40 cases have been reported until 1997 (Alpsoy E, Yilmaz E, Aykol A. Hyperkeratosis of the nipple: report of two cases. J Dermatol 1997;24:43-45). The disease has a benign course and may only be a cosmetic problem. Different modalities have been used in the treatment of NHNA. In our case treatment with topical retinoic acid induced an acceptable response.