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Dermatologic Differential Diagnosis.pdf. - Famona Site

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lipoatrophic streaks extend down legs; high nasal bridge,

prominent jaw, large ears, fat over suprapubic area and labia

majora, fat pads over buttocks; hypotonia Textbook of Neonatal

Dermatology, p.432, 2001

Circumareolar telangiectasia AD 126:1656, 1990

Galactorrhea of newborn – witches’ milk

Mamillary fistula

Pearls (milia) in newborn of areolae, scrotum, and labia majora

of newborn Rook p.452, 1998, Sixth Edition

Rudimentary nipples Humangenetik 15:268–269, 1972

Supernumery nipples (accessory nipple or nipple nevus)

Textbook of Neonatal Dermatology, p.118, 2001; Cutis

62:235–237, 1998

DRUG-INDUCED

Diethylstilbestrol – florid papillomatosis after diethylstilbestrol

therapy in males

Nipple priapism JAMA 258:3122, 1987

EXOGENOUS AGENTS

Nipple rings Rook p.3158, 1998, Sixth Edition

INFECTIONS AND INFESTATIONS

Candida albicans – lactation Aust NZ J Obstet Gynaecol

31:378–380, 1991

Herpes simplex Tyring p.83, 2002

Lyme disease (Borrelia burgdorferi) – lymphocytoma cutis;

bluish–red plaque of nipple or areola JAAD 49:363–392, 2003;

JAAD 47:530–534, 2002; Cutis 66:243–246, 2000; JAAD

38:877–905, 1998

Molluscum contagiosum

Mycobacterium abscessus – subareolar abscess due to nipple

piercing Clin Inf Dis 33:131–134, 2001

Mycobacterium tuberculosis – lupus vulgaris Cutis 53:246–248,

1994

Scabies Rook p.1460–1461, 1998, Sixth Edition

Syphilis – primary chancre; secondary Rook p.1244, 1998,

Sixth Edition

INFILTRATIVE LESIONS

Mucinosis of the areolae – manifestation of CTCL

Clin Exp Dermatol 21:374–376, 1996

INFLAMMATORY LESIONS

Lactation mastitis JAMA 289:1609–1612, 2003

METABOLIC DISEASES

Addison’s disease – hyperpigmentation of nipples Rook p.1779,

1998, Sixth Edition

Androgen excess – hyperpigmentation of areolae, axillae,

external genitalia, perineum Ghatan p.165, 2002, Second

Edition

Nipple retraction of menopause Br Med J 309:797–800, 1994

Pregnancy – hyperpigmentation of nipples Rook p.1780,3149,

1998, Sixth Edition

NIPPLE LESIONS, INCLUDING NIPPLE WITH MULTIPLE PAPULES 365

NEOPLASTIC DISEASES

Basal cell carcinoma – red plaque Derm Surg 27:971–974,

2001; Cutis 54:85–92, 1994; including pigmented basal cell

carcinoma (black nipple) AD 125:536–539, 1989

Blue nevus

Breast cancer – female or male; puckered nipple

Carcinoma of the breast (primary), metastatic to nipple –

cellulitis-like appearance of primary inflammatory breast

carcinoma JAAD 43:733–751, 2000; female or male breast

carcinoma – puckered nipple

Dermatofibroma – atypical polypoid dermatofibroma

JAAD 24:561–565, 1991

Epidermal nevus Paris Med 28:63–66, 1938

Epidermoid cyst

Fox–Fordyce disease Rook p.3162, 1998, Sixth Edition

Granular cell myoblastoma – nipple-like lesion AD

121:927–932, 1985

Hidradenoma papilliferum Hautarzt 19:101–109, 1968

Hidradenoma

Leiomyomas AD 127:571–576, 1991

Leiomyosarcoma – blue–black; also red, brown, yellow or

hypopigmented JAAD 46:477–490, 2002

Lymphoma – cutaneous T-cell lymphoma mimicking

hyperkeratosis of the nipple (hyperkeratosis areolae mammae)

JAAD 41:274–276, 1999

Lymphocytoma cutis

Melanoma – primary, metastatic, amelanotic

Milium

Neurofibromas Rook p.3162, 1998, Sixth Edition

Nevi, melanocytic

Nevoid hyperkeratosis of the nipple JAAD 46:414–418, 2002;

BJD 142:382–384, 2000; JAAD 41:325–326, 1999

Paget’s disease of the breast (nipple) Rook p.1677–1678,2709,

1998, Sixth Edition; Dermatologica 170:170–179, 1985;

Surg Gynecol Obstet 123:1010–1014, 1966

Prostatic carcinoma metastases JAAD 18:391–393, 1988

Sebaceous hyperplasia of areola JAAD 13:867–868, 1985

Seborrheic keratoses Rook p.3161, 1998, Sixth Edition

Steatocystoma multiplex

Syringocystadenoma papilliferum

Syringomas

Syringomatous adenomas of the nipple

NORMAL

Montgomery’s tubercles JAAD 10:929–940, 1984; BJD

86:126–133, 1972

PRIMARY CUTANEOUS DISEASES

Acanthosis nigricans JAAD 52:529–530, 2005; JAAD 31:1–19,

1994

Epidermolytic hyperkeratosis – verrucous plaques of nipples

Rook p.1506, 1998, Sixth Edition

Erosive adenomatosis (papillary adenomatosis) of the nipple –

blood-stained or serous discharge; enlarged nipple; eroded

nipple; erythema, ulcer, crusted dermatitis, granular

appearance, papule on nipple JAAD 47:578–580, 2002;

JAAD 43:733–751, 2000; superficial papillary adenomatosis of

the nipple JAAD 33:871–875, 1995; JAAD 12:707–715, 1985

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