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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

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...

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Autores principales: Tocco-Tussardi, Ilaria, Mobargha, Nathalie, Bassetto, Franco, Vindigni, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5048619/
https://www.ncbi.nlm.nih.gov/pubmed/27697695
http://dx.doi.org/10.1016/j.ijscr.2016.09.027
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author Tocco-Tussardi, Ilaria
Mobargha, Nathalie
Bassetto, Franco
Vindigni, Vincenzo
author_facet Tocco-Tussardi, Ilaria
Mobargha, Nathalie
Bassetto, Franco
Vindigni, Vincenzo
author_sort Tocco-Tussardi, Ilaria
collection PubMed
description 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.
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spelling pubmed-50486192016-10-07 Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report Tocco-Tussardi, Ilaria Mobargha, Nathalie Bassetto, Franco Vindigni, Vincenzo Int J Surg Case Rep Case Report 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. Elsevier 2016-09-22 /pmc/articles/PMC5048619/ /pubmed/27697695 http://dx.doi.org/10.1016/j.ijscr.2016.09.027 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Tocco-Tussardi, Ilaria
Mobargha, Nathalie
Bassetto, Franco
Vindigni, Vincenzo
Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report
title Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report
title_full Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report
title_fullStr Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report
title_full_unstemmed Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report
title_short Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report
title_sort radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5048619/
https://www.ncbi.nlm.nih.gov/pubmed/27697695
http://dx.doi.org/10.1016/j.ijscr.2016.09.027
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