Spontaneous Regression Of Long-standing Bilateral Nevoid Hyperkeratosis Of The Nipple And Areola In A Young Female: A Case Report

Abstract

Dear Editor, Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare, acquired, benign condition characterized by hyperkeratosis and hyperpigmentation affecting the nipple and/or areola. It may be idiopathic or associated with various dermatoses such as epidermal nevus, acanthosis nigricans, Darier's disease, chronic eczema, Tcell lymphoma, and endocrinopathies.1 NHNA typically affects women in the second or third decades and thus entails a significant cosmetic morbidity. There has currently been no recommended treatment. This report, presents, to our best knowledge, the first case of a young female NHNA, whose skin lesions spontaneously disappeared without treatment. An otherwise heathy 23yearold Japanese female presented with a 10year history of several brownish papules with mild itching on bilateral areolae. Preceded topical corticosteroids were almost unhelpful for her symptomatic relief. The skin lesions have gradually increased in number, some of which coalesced with each other and newly developed on the nipples. On examination, multiple darkbrownish scaly papules were localized on bilateral areolae and nipples (Figure 1a, b). The lesional skin pathology revealed a wavy projection of mild acanthosis with prominent orthohyperkeratosis, comedolike keratin plugs, and epidermal basal hyperpigmentation (Figure 1c). Patchy lymphocytic infiltrates were present in the upper dermis (Figure 1d). Dermoscopic findings showed milialike cysts and comedolike openings (Figure 1e).