Nevoid hyperkeratosis of the areola misinterpreted as mycosis fungoides

Rosman, Ilana S.; Hepper, Donna M.; Lind, Anne C.; Anadkat, Milan J.

doi:10.1111/j.1600-0560.2012.01885.x

Cited by 11 publications

(12 citation statements)

References 22 publications

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“…In the classification system of NHNA proposed by Pérez-Izquierdo [ 4 ], among other dermatologic diseases lymphoma was also considered as causing secondary involvement of the nipple-areola complex. On the other hand, only a few well-documented cases have been reported pertaining to this relationship, which do not appear to describe a uniform condition [ 5 , 6 , 7 , 8 , 9 ]. According to a review addressing the clinicopathological spectrum of MF, lesions of vegetating/papillomatous MF may resemble acanthosis nigricans or seborrheic keratosis which can be seen on the nipple and areola [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Though acanthosis nigricans, verrucous nevus, seborrheic keratosis, dermatosis, ichthyosis, lymphoma, Darier's disease, eczema and drug reactions were cited as secondary causes of NHNA in this classification, a pathogenetic mechanism for these associations was not proposed. There have been anecdotal reports of an association between NHNA and mycosis fungoides (MF) [ 5 , 6 , 7 , 8 ], and of cases mimicking MF and exhibiting histopathological changes such as intraepidermal collections of lymphocytes [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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The Dilemma of Coexisting Nevoid Hyperkeratosis of the Nipple and Areola in Mycosis Fungoides: A Report of Three Cases

Ekinci¹,

Sarı²,

Büyükbabanı³

et al. 2015

Dermatopathology

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Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare clinicopathological entity showing persistent and strictly localized hyperkeratotic lesions of the nipple, areola or both with unknown etiopathogenesis. A similar clinical appearance may also be seen in different diseases with specific histopathological features. There are a few anecdotal reports on the association of NHNA with mycosis fungoides (MF), but they do not describe a uniform condition. In this report, we present 3 patients with hyperkeratotic lesions of the nipple and areola associated with MF but showing different histopathological features. We also review similar cases in the literature and discuss possibilities concerning this association. Two of our cases represent the association between MF and NHNA without histopathological features of MF on the nipple-areola complex. The other case represents hyperkeratosis of the nipple and areola with specific histological and immunohistochemical features of MF. Hence, we would like to hypothesize that MF may involve the nipple and areola and have an appearance similar to NHNA. Intriguingly, however, NHNA may occasionally also be seen in association with MF. However, this peculiar association requires further explanation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Dilemma of Coexisting Nevoid Hyperkeratosis of the Nipple and Areola in Mycosis Fungoides: A Report of Three Cases

Ekinci¹,

Sarı²,

Büyükbabanı³

et al. 2015

Dermatopathology

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“…There are also reports of NHNA mimicking mycosis fungoides. 8 Although there are no known hormone alterations associated with NHNA, endocrinological factors have been suggested in its pathogenesis because NHNA predominantly occurs in adolescent girls with onset soon after menarche, 1,5,7 or in the third decade of life associated with pregnancy. 3 A few cases have been reported of NHNA in men, presenting after diethylstilbestrol therapy for prostatic adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…Clinically and histologically, it is difficult to distinguish NHNA from acanthosis nigricans. There are also reports of NHNA mimicking mycosis fungoides …”

mentioning

confidence: 99%

Naevoid hyperkeratosis of the nipple and areola: an extensive form in two adolescent Filipino females

Soriano

Piansay-Soriano

2014

Clin Exp Dermatol

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Few cases of naevoid hyperkeratosis of the nipple and areola (NHNA) have been documented since the condition was first described in 1923. A recent PubMed search (Mar 2014) yielded 107 cases of NHNA in the world literature, mostly female patients with adolescent-onset disease. We report the first two cases of adolescent-onset NHNA from the Philippines. To our knowledge, these are also the first two cases of extensive bilateral NHNA reported in which the lesions have extended beyond the areolae affecting the surrounding periareolar skin, covering almost the entire breast. Medical treatment of NHNA has been commonly associated with treatment failure or recurrence after treatment cessation, requiring intermittent therapy. However, our two cases had successful outcomes with medical treatment using a combination topical steroid/salicylic acid ointment with > 2 years of follow-up.

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“…Cutaneous lymphomas may imitate diverse diagnoses on both clinical and histological grounds [ 7 ] . There have been anecdotal reports that histopathologic changes seen in biopsies from HKNA lesions may mimic mycosis fungoides [8][9][10][11] . In all these cases, key histopathologic fi ndings imitating mycosis fungoides such as lymphoid epidermotropism and focal aggregation of lymphocytes resembling Pautrier's microabscesses have been observed.…”

Section: Fokus Dermatopathologiementioning

confidence: 99%