Cleft-like appearance of accessory nipple in digital microscopy* * Study conducted at the Hitit University, Faculty of Medicine, Department of Dermatology – Çorum, Turkey.

Engin Senel About the author

Dear Sir,

Accessory nipples are solitary or multiple rudimentary nipples developing along the two vertical 'milk-lines'. Most cases are sporadic and asymptomatic. Accessory nipple occurs in 1-6% of the population and affects both genders equally.1Grossl NA. Supernumerary breast tissue: historical perspectives and clinical features. South Med J. 2000;93:29-32. It is often mistaken as dermatofibroma in clinical or dermatoscopic examination. Blum et al. have reported a case of accessory nipple indistinguishable from dermatofibroma, with dermatoscopic features such as peripheral pigment network and central scar-like white-colored area.2Blum A, Roehm S. Accessory nipple looks like dermatofibroma in dermoscopy. Arch Dermatol. 2003;139:948-9. Oztas and Gurer detected a cleft-like appearance in the dermatoscopic evaluation of four of their five patients.3Oztas MO, Gurer MA. Dermoscopic features of accessory nipples. Int J Dermatol. 2007;46:1067-8. Herein, we would like to point out the potential of portable digital microscopy for the diagnosis of accessory nipple in clinical practice. In our clinic, we use a Celestron handheld digital Microscope model #44301, at 30-fold magnification, provided with a focus ring and six LED ring illuminators. It has a resolution of 1280 x 1024 pixels and provides JPEG-format digital images, which are downloaded via USB connection to a personal computer.

A 30-year-old man presented with a congenital 4x5 mm brownish-pink nodule in his right subcostal region (Figure 1). We could not detect a cleft-like appearance in dermatoscopic evaluation. Dermatoscopic examination disclosed a dermatofibroma-like appearance with peripheral pigment network and a central scar-like area (Figure 2). However, the cleft-like appearance was observed in digital microscopy (Figure 3).

FIGURE 1
A 5x5 mm brownish-pinknodule along the right milkline
FIGURE 2
Dermatoscopy of accessory nipple with peripheral pigment network and a central scar-like patch
FIGURE 3
Digital microscopy of accessory nipple (Arrow shows cleft-like appearance responding to nipple tip)

A portable digital microscope with 30- to 100-fold magnification is a more affordable imaging device than a dermatoscope and it can be helpful in the diagnosis of accessory nipple in clinical practice.

  • Financial Support: None.
  • How to cite this article: Senel E. Cleft-like appearance of accessory nipple in digital microscopy. An Bras Dermatol. 2015; 90(3):434-5.
  • *
    Study conducted at the Hitit University, Faculty of Medicine, Department of Dermatology – Çorum, Turkey.

Reference

  • 1
    Grossl NA. Supernumerary breast tissue: historical perspectives and clinical features. South Med J. 2000;93:29-32.
  • 2
    Blum A, Roehm S. Accessory nipple looks like dermatofibroma in dermoscopy. Arch Dermatol. 2003;139:948-9.
  • 3
    Oztas MO, Gurer MA. Dermoscopic features of accessory nipples. Int J Dermatol. 2007;46:1067-8.

Publication Dates

  • Publication in this collection
    June 2015

History

  • Received
    07 Aug 2014
  • Accepted
    02 Oct 2014
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