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Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery. Maxillofacial Surg, S-75185 Uppsala, Sweden.;Univ Padua, Dept Neurosci, Clin Plast & Reconstruct Surg, Via Giustiniani 2, I-35128 Padua, Italy..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery. Maxillofacial Surg, S-75185 Uppsala, Sweden..
Univ Padua, Dept Neurosci, Clin Plast & Reconstruct Surg, Via Giustiniani 2, I-35128 Padua, Italy..
Univ Padua, Dept Neurosci, Clin Plast & Reconstruct Surg, Via Giustiniani 2, I-35128 Padua, Italy..
2016 (English)In: International journal of surgery case reports, ISSN 2210-2612, E-ISSN 2210-2612, Vol. 28, p. 117-120Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Nevoid hyperkeratosis of the nipple and/or areola (NHNA) is a benign lesion with a female predominance and an aesthetically disturbing appearance. Spontaneous remission is not reported and medical treatments proposed so far have shown variable results. PRESENTATION OF CASE: We describe a rare case of an extensive variant of NHNA covering almost the entire breasts' surface. At present, only three other reports are present in the literature. Medical treatment proved not completely effective and the patient was also affected by a significant breast asymmetry hypertrophy. Therefore, NHNA was managed surgically with excision of the areolar affected portions while performing breast reduction-lift. The result was satisfactory and without recurrence of lesions at 5-year follow-up. DISCUSSION: This case reported favorable outcomes of surgery for NHNA. Reports of success with these procedures are still limited, but the promising results in terms of radicality and aesthetic outcome suggest it should be offered to patients as a viable therapeutic option. CONCLUSION: Indications for surgical treatment of NHNA can be: unsatisfying response to topical agents; young patients who want to restore the aesthetic appearance of the breast; and patients with concomitant indication for corrective surgery of the breast. Advantages are: predictable time of healing; predictable final result; radical excision of the affected tissue; and possibility of histologic analysis of the whole areola. In rare cases of lesions extending to the breast, preliminary treatment with topical agents can limit the extent of excision. Management and treatment should always be tailor-made for each individual case.

Place, publisher, year, edition, pages
2016. Vol. 28, p. 117-120
Keywords [en]
Nevoid hyperkeratosis, Areola, Hydroquinone, Kojic acid, Breast asymmetry, Breast ptosis
National Category
Surgery
Identifiers
URN: urn:nbn:se:uu:diva-312718DOI: 10.1016/j.ijscr.2016.09.027ISI: 000387796500031PubMedID: 27697695OAI: oai:DiVA.org:uu-312718DiVA, id: diva2:1064462
Available from: 2017-01-12 Created: 2017-01-12 Last updated: 2017-11-29Bibliographically approved

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