Unilateral Nipple Rash In A Man

A man in his 50s was referred to the breast surgery clinic with a one month history of an exudating, oedematous, itchy right nipple-areolar complex. He had experienced hay fever in the past but reported no recent contact with known irritants or allergens. He had not used topical steroids before presentation. On examination, both the right nipple and the areola were erythematous, thickened, and excoriated (fig 1). The left nipple was unaffected, and there were no palpable breast lumps or axillary lymphadenopathy bilaterally. Lesions were not present elsewhere. Mammography and ultrasonography only showed thickened right areolar skin. Right areolar punch biopsy revealed epidermal hyperplasia, hyperkeratosis/parakeratosis, and spongiosis with subepithelial inflammation.\n\n\n\nFig 1 \nRight nipple eczema, showing erythema, oedema, and excoriation of …