# Unilateral Nevoid Hyperkeratosis of the Nipple and Areola: A Case Report of a Rare Entity

## TL;DR

A rare benign skin condition affecting the nipple and areola is reported in a 72-year-old man, highlighting the need to distinguish it from cancerous diseases.

## Contribution

This case report documents a rare unilateral male presentation of nevoid hyperkeratosis of the nipple and areola.

## Key findings

- The patient showed unilateral verrucous plaques on the nipple and areola with no signs of malignancy.
- Histopathology confirmed the diagnosis of NHNA with features like hyperkeratosis and lymphocytic infiltrate.
- Topical corticosteroids led to a good clinical response in the patient.

## Abstract

Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare benign skin disorder that presents as hyperkeratotic, verrucous plaques involving one or both nipples and areola. Although the lesions are asymptomatic, they can raise cosmetic concerns and may clinically mimic serious conditions like Paget’s disease. Histopathology examination is essential for diagnosis and for ruling out malignant conditions. We report a 72-year-old Kuwaiti male with unilateral verrucous plaques persistent over the nipple and areola for six months. Physical examination and mammography revealed no abnormalities, and biopsy showed marked hyperkeratosis, acanthosis, papillomatosis and superficial lymphocytic infiltrate without atypia, consistent with NHNA. The patient was treated with topical corticosteroids with a good response. This case highlights a unilateral male presentation of NHNA, emphasizing the importance of recognizing this benign entity from other malignant diseases like Paget’s disease. Biopsy is essential for accurate diagnosis, ensuring malignancies are excluded, and appropriate therapy is initiated.