Nipple dermatitis
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Synopsis
Nipple dermatitis is a localized dermatitis of the areola and/or nipple. It is frequently associated with breastfeeding, friction from jogging, and other contact irritants such as soaps, detergents, or chlorine. It is more common in atopic individuals; in fact, nipple eczema is considered a minor diagnostic criterion for atopic dermatitis. It may also be seen in cases of nummular dermatitis. Because nipple dermatitis may mimic Paget disease, if it does not respond to simple therapy with a mild-to-mid-potency topical steroid, a biopsy should be performed.
Codes
ICD10CM:
L20.89 – Other atopic dermatitis
SNOMEDCT:
237463009 – Eczema of nipple
L20.89 – Other atopic dermatitis
SNOMEDCT:
237463009 – Eczema of nipple
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Consider Paget disease if there is a unilateral plaque, especially in a middle-aged to older woman.
- If nipple discharge is co-existent, consider intraductal papillary carcinoma.
- Consider an occult contact allergy, such as to preservatives or fragrances, as a cause.
- Erosive adenomatosis of the nipple may present with discharge, a crusted or eroded plaque, or nodularity.
- Benign Toker cell hyperplasia is an extremely unusual condition where normal Toker cells of the breast tissue, particularly of supernumerary nipple, are hyperplastic but lack the malignant qualities of mammary Paget disease.
- Squamous cell carcinoma in situ may assume an eczematous-appearing plaque of the nipple and periareolar skin, but the condition is derived from malignant keratinocytes.
- Hyperkeratosis of the nipple and areola
- Clear cell acanthoma
- Seborrheic keratosis
- Psoriasis
Best Tests
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Management Pearls
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Therapy
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References
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Last Updated:08/10/2021
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Nipple dermatitis