Patient's question:
Main symptoms: Nipple itching, yellowish-brown crust and discharge after scratching. The right nipple, which is itchy, is significantly larger and thicker than the left, while the left nipple shows no itching symptoms. Applying ointments like Pikang Cream temporarily resolves the itching and crust, but symptoms recur after discontinuation. After visiting the hospital and taking the prescribed eczema medication, the condition improved significantly, resembling a cure. However, symptoms reappear upon stopping the medication. This has been going on for over three years. I am very worried it might be papillary eczematoid carcinoma. Please provide an explanation.Doctor's answer:
Hello, Paget's disease of the nipple, also known as nipple eczematoid carcinoma, is a type of breast cancer that presents as eczematoid changes on the nipple. Initially, patients may experience no symptoms, but some may only notice itching or a burning sensation in the nipple. The clinical presentation often includes scaling of the nipple epidermis, a small amount of nipple discharge that forms crusts, and when the crust is removed, a fresh red erosion is visible. The skin wound may take a long time to heal, and the erosion can gradually spread to surrounding areas, potentially affecting the areola and breast. The nipple may retract, and as the condition worsens, part or all of the nipple may become necrotic. The crust can be removed, and a saline-soaked cotton ball can be used to wipe the discharge, creating a smear for cytological examination. If cancer cells are found, the diagnosis can be confirmed. If the cytological examination is negative, the disease should not be ruled out, and a pathological tissue biopsy should be performed for definitive diagnosis.