Your patient is a 64-year-old female who presents with complaints of a red, scaly rash on her nipple and areola of one breast. It has been present for a few months. There is no mass or nipple discharge. You should be suspicious of:
A. Contact dermatitis
B. Mastitis
C. Paget's disease
D. Eczema
ANS: C
In Paget's disease of the breast, the patient may describe the persistence of skin changes for several months. The typical presentation involves skin changes of the nipple and/or areola, with the nipple being involved first. The condition does not always involve a palpable mass or nodule. The skin changes of the nipple and areola range from scaling redness to various degrees of ulceration.
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