Treatment of Nevoid Hyperkeratosis of the Nipple and Areola Using a Radiofrequency Surgical Unit

Abstract

BACKGROUND. Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare condition of unknown etiology. Verrucous thickening and pigmentation of the nipple and areola are the main features of the condition. Different therapeutic options, both medical and surgical, have been described.OBJECTIVE. To use a radiofrequency surgical unit to treat an NHNA case, which was unresponsive to keratolytic therapy. MATERIALS AND METHODS. The lesions of the nipple and areolaswere excised tangentially with a diamond-shaped electrode of a radiofrequency surgical unit under local anesthesia. RESULTS. The patient had a good cosmetic appearance after the treatment, and there was no recurrence at the ninth postoperative month.CONCLUSION. Radiofrequency for tangential excision in the treatment of NHNA lesions that have not responded to medical therapy can be an alternative surgical method.

Unilateral nevoid hyperkeratosis of the nipple and areola in a Saudi female

“…Cryotherapy has also been used successfully in the treatment of NHNA, with improvement noted after five sessions (with 20 s of cryotherapy per session) in a female patient who failed to respond to topical keratolytic agents [16]. In addition, surgical treatment modalities have been described, including radiofrequency surgery [17].…”

Nevoid hyperkeratosis of the areola misinterpreted as mycosis fungoides

“…Nevoid hyperkeratosis is typically asymptomatic, although it may be occasionally pruritic. Various treatment modalities have been reported including topical corticosteroids, topical and oral retinoids, topical keratolytics, surgical techniques including cryotherapy, excision and laser or radiofrequency ablation 3,4,9–14 . However, treatment is rarely definitive and although nevoid hyperkeratosis is a benign condition, it can cause cosmetic concerns and rarely may interfere with breast‐feeding 4,15 …”

Pregnancy-Associated Hyperkeratosis of the Nipple

“…19 A sustained remission of HNA has been maintained with low-dose acitretin combined with calcipotriol. 7 Surgical modalities, such as cryotherapy, 9 shave excision, 28 surgical removal, 29 carbon dioxide laser, 30 and radiofrequency ablation, 31 have been used in unresponsive cases of HNA and might also find utility here. Symptomatic, recalcitrant lesions showed a complete response to curettage in 1 of our patients.…”