Unilateral nevoid hyperkeratosis of the nipple and areola in a Saudi female

Abstract

Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare, benign condition of unknown origin that is characterized by a hyperpigmented, hyperkeratotic verruca plaque over the nipple and/or areola. NHNA usually occurs bilaterally, but is sometimes present unilaterally. We present a case of a 21-year-old Saudi female who presented at dermatology outpatient clinic with a 3-year history of skin darkening and thickening of the left nipple, associated with moderate itching. The patient was diagnosed with unilateral NHNA on the basis of clinical presentation and skin-punch biopsy findings of epidermal orthokeratotic hyperkeratosis, mild papillomatosis, basal-layer hyperpigmentation and irregular filiform-pattern epidermal acanthosis. To the best of our knowledge, this case represents the first report of NHNA with unilateral presentation in a Saudi female.

Keywords

• Nevoid hyperkeratosis
• Nipple
• Areola