ABSTRACT
This chapter presents the case study of a 68-year-old patient. A 68-year-old patient presents with a 3-year history of a rash surrounding her right nipple, which is red and mildly pruritic. She denies any discharge from the nipple. Topical steroids prescribed by her GP had been ineffective so she was referred to the dermatology out-patient clinic. There is a sharply demarcated erythematous plaque surrounding the right nipple with some slight overlying scale, measuring 6 cm in diameter. Asymmetrical ‘eczema’ of the nipple that is unresponsive to topical steroids should always raise the possibility of an underlying malignancy of the breast. Paget’s disease is uncommon and involves the nipple or areola, and manifests as erythematous, well-demarcated plaques with overlying scale. A similar condition called extramammary Paget’s disease may occur away from the nipple and present with a similar eczema-like eruption, usually around the female/male anogenital region or axilla.
