Case analysis uncovers diagnosis of nevoid hyperkeratosis in a 44-year-old woman, highlighting clinical features and necessary differential diagnoses.
Nevoid hyperkeratosis of nipple and areola (NHNA) is a rare benign skin disease, sparsely reported worldwide. The bothersome symptoms and unsightly appearance are worrisome to the patient. A 44-year-old female presented an eight-month history of an itchy, well-defined, non-tender plaque with a papillomatous surface over the areola of the right breast. Differential diagnoses including eborrheic keratosis, erosive adenomatosis of the nipple, NHNA, and Paget’s disease were considered. On dermoscopy and biopsy, a final diagnosis of NHNA was made. Around 120 cases of NHNA have been reported worldwide to date, out of which 80% are among women aged 20–30 years. Etiology is proposed to be hormonal, altered expression of keratin genes among others. Dermoscopic features of NHNA are rarely reported, and they aid in the confirmation of diagnosis along with histopathology. NHNA is a diagnosis of exclusion. A clinical, dermoscopic, and histopathological correlation is invaluable in its diagnosis and to rule out malignant lesions.
No takes yet. Share an insight, caveat, or question.
Pradnya Joshi (2025) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: