Multiple choice: HYPERKERATOTIC, PIGMENTED AND WARTY PLAQUES OF THE NIPPLE

Abstract

A 24-year-old woman with no significant personal history consulted for asymptomatic lesions on both nipples that began in adolescence. She reported that they began as isolated hyperpigmented papules that progressively increased in size, coalescing and occupying the entire surface of the nipple. Physical examination revealed warty, hyperkeratotic, and hyperpigmented plaques on both nipples. The lesions did not affect the areolas or other body locations. She did not have adenomegaly. Laboratory tests were performed that included hormonal measurements of estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin, with no abnormalities. Likewise, the ultrasound study of the breasts was normal. A biopsy of the skin lesion was taken and hyperkeratosis, papillomatosis, and mild epidermal acanthosis were observed.