By Gary M. White, MD

Paget's Disease

Paget's disease (PD) represents a chronic, slowly enlarging lesion on the breast which overlies an intraductal breast carcinoma.


A slowly expanding, red, scaly plaque is seen unilaterally on one nipple. The lesion may ulcerate and/or a mass may be felt below. Often, the condition is mistaken for eczema and treated with topical steroids for years. A biopsy should be taken of any unilateral chronic, red, scaly lesion of the nipple. A pigmented variant occurs.


Surgical excision by a specialist is necessary.


Pigmented mammary Paget's disease misdiagnosed as malignant melanoma. Ann Dermatol. 2014 Dec;26(6):747-750

Paget's disease may be pigmented. Ann Dermatol. 2011 Feb; 23(1): 73–75

Nice picture of a larger lesion. Biomed Imaging Interv J. 2011 Apr-Jun; 7(2): e16

Nice case illustrating how very small pigmented macules of the nipple may represent Paget's disease. JAAD June 2011 Volume 64, Issue 6, Pages e114–e116

Paget's disease in a 27 year old woman. The lesion closely resembled eczema, but was not. Int J Clin Exp Med. 2015; 8(3): 4694–4696.


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