Case Report
Nevoid Hyperkeratosis of the Nipple and Areola: A Bilateral Idiopathic Presentation in a Young Female
Shatanik Bhattacharya
Department of Dermatology, Venereology & Leprosy, Prafulla Chandra Sen Government Medical College, Arambag, India
*Corresponding author:Dr. Shatanik Bhattacharya, Department of Dermatology, Venereology & Leprosy, Prafulla Chandra Sen Government Medical College, Arambag, India E-mail Id: shatanik.bhattacharya.97@gmail.com
Copyright: © 2026 Bhattacharya S. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article Information:Submission: 10/02/2026; Accepted: 23/03/2026; Published: 25/03/2026
Abstract
Background: Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare benign dermatosis characterized by verrucous thickening and hyperpigmentation of the nipple–areola complex. It is frequently misdiagnosed due to its resemblance to inflammatory and malignant conditions.
Case Report: A 25-year-old female presented with a two-year history of progressive discoloration and thickening of both areolas. The condition began as pink, scaly eczematous plaques that gradually darkened and became verrucous. There was no history of atopy, nipple discharge, malignancy, drug intake, or systemic illness. Examination revealed bilateral diffuse brown hyperpigmentation with papillomatous thickening of the nipple–areola complex. No mass, lymphadenopathy, or nipple retraction was detected. Histopathology showed marked acanthosis, papillomatosis, filiform rete ridges with anastomosis, basal layer hyperpigmentation without melanocytic proliferation, and mild upper dermal fibrosis. A diagnosis of idiopathic NHNA was established.
Conclusion: Awareness of NHNA and its clinicopathological correlation is essential to avoid misdiagnosis, particularly of Paget’s disease or malignant acanthosis nigricans. Early recognition allows appropriate conservative or procedural management.
Case Report: A 25-year-old female presented with a two-year history of progressive discoloration and thickening of both areolas. The condition began as pink, scaly eczematous plaques that gradually darkened and became verrucous. There was no history of atopy, nipple discharge, malignancy, drug intake, or systemic illness. Examination revealed bilateral diffuse brown hyperpigmentation with papillomatous thickening of the nipple–areola complex. No mass, lymphadenopathy, or nipple retraction was detected. Histopathology showed marked acanthosis, papillomatosis, filiform rete ridges with anastomosis, basal layer hyperpigmentation without melanocytic proliferation, and mild upper dermal fibrosis. A diagnosis of idiopathic NHNA was established.
Conclusion: Awareness of NHNA and its clinicopathological correlation is essential to avoid misdiagnosis, particularly of Paget’s disease or malignant acanthosis nigricans. Early recognition allows appropriate conservative or procedural management.
Keywords:Nevoid Hyperkeratosis; Nipple; Areola; Verrucous Lesion; Benign Dermatosis