Keratosis areolae mammae acquisita L 82

Rare, acquired, mostly bilateral cornification disorder of the nipple and nipple. Acquired nipple keratosis can occur in both women and men.

Acquired nipple keratoses can be idiopathic, reactive inflammatory, but can also occur as a paraneoplastic syndrome in malignant tumors; it is assumed that excessive growth factors (see below: Acanthosis nigricans) are produced which inhibit the proliferation of the epidermis at the best part of the nipple. (see also Acanthosis nigricans; see also Leser-Trélat syndrome).

• acquired warty hyperkeratosis of the areolae mammae
• Sharp demarcation from the surrounding skin
• Brown-black-brown
• Painlessness
  • m:w=1:1
  • Pregnancy
  • Drug side effects (Vemurafenib)
  • Occurs together with other acquired cornification disorders (Papillomatosis confluens et reticularis; Acanthosis nigricans)
  • possible as a paraneoplastic syndrome
  • caused by Pityrosporum spp.

A causal therapy is only possible for those forms that occur in the context of an inflammatory disease of the integument. Here, treatment of the underlying disease will lead to improvement (or healing) of the findings.

In the idiopathic forms, which may be accompanied by acanthosis nigricans, a tumor search should be performed.

Locally, bland-nursing therapies with mild keratolytic externals can be used. This can lead to a moderate improvement of the findings. However, the therapy must be applied permanently.

1. Polat Ekinci A et al (2015) The Dilemma of Coexisting Nevoid Hyperkeratosis of the Nipple and Areola in Mycosis Fungoides: A Report of Three Cases. Dermatopathology (Basel) 2:61-66.
2. Elsner E (1998) Guess What! Idiopathic hyperkeratosis and papillomatosis areolae mammae. Eur J Dermatol 8:131-132
3. Higgins HW et al (2013) Pregnancy-associated hyperkeratosis of the nipple: a report of 25 cases. JAMA Dermatol 149:722-726
4. Li C et al (2014) Malassezia associated hyperkeratosis of the nipple in young females: report of three cases. Indian J
5. Dermatol Venereol Leprol 80:78-80
6. Martinez-Garcia E et al (2015) Vemurafenib-induced hyperkeratosis of the areola treated with topical adapelene. Clin Exp Dermatol doi: 10.1111/ced.12606
7. Parimalam K et al (2015 ) Nipple Hyperkeratosis Dueto Malassezia Furfur Showing Excellent Response to Itraconazole. Indian J Dermatol 60:324