Breast Unit, Department of Gynecology, University Hospital of Mútua Terrassa, University of Barcelona, Terrassa, Spain.
Department of Nursing, Breastfeeding Promotion Programme, ASSIR Mollet, Institut Català de la Salut, Barcelona, Spain.
Int J Dermatol. 2017 Dec;56(12):1451-1454. doi: 10.1111/ijd.13747. Epub 2017 Sep 27.
Erosive adenoma of the nipple (EAN) is a benign condition that involves major ducts of the nipple. Its clinical presentation may resemble other disorders. Complete removal of the nipple is often suggested because of frequent relapse. However, adverse cosmetic and functional results have prompted clinicians to look for other more conservative options.
To present a case of EAN successfully treated using Mohs micrographic surgery (MMS) and summarize differential diagnosis and treatment.
A 40-year-old woman with EAN was diagnosed by immunohistochemical markers after clinical suspicion. We have reviewed other cases treated with MMS in the literature.
In this patient, lesion size was 0.8 cm and the margin specimen was 1 × 0.9 × 0.2 cm, with EAN as histopathologic diagnosis. No atypia or malignancy was reported. Final esthetic outcome was reached with only one session, under local anesthesia and on an outpatient basis.
Dermatologic lesions appearing on the nipple's surface should be closely followed. Paget's disease, carcinoma or proliferative lesions like EAN have to be considered, and such conditions require different surgical approaches. Traditional complete removal of the nipple is performed in many cases, but it may result in over-treatment and unfavorable cosmetic outcome. MMS is frequently used in dermatologic surgery to treat malignant lesions with a high cure rate, avoiding excess tissue excision and leading to better patient satisfaction.
EAN can be successfully treated by minimal resection, especially if early diagnosis is done. MMS offers a better aesthetic outcome than traditional total excision.
乳头腐蚀性腺瘤（EAN）是一种涉及乳头主要导管的良性病变。其临床表现可能类似于其他疾病。由于频繁复发，通常建议彻底切除乳头。然而，不良的美容和功能结果促使临床医生寻求其他更保守的选择。
介绍一例成功采用Mohs 显微外科手术（MMS）治疗的 EAN 病例，并总结鉴别诊断和治疗方法。
对一例临床怀疑为 EAN 的 40 岁女性患者，通过免疫组织化学标志物进行诊断。我们回顾了文献中其他采用 MMS 治疗的病例。
在该患者中，病变大小为 0.8cm，切缘标本大小为 1×0.9×0.2cm，组织病理学诊断为 EAN。未见非典型或恶性病变。仅在一次局部麻醉下的门诊就诊中，就达到了最终的美容效果。
出现在乳头表面的皮肤病损应密切随访。需要考虑 Paget 病、癌或增殖性病变，如 EAN，这些情况需要不同的手术方法。传统的乳头完全切除术在许多情况下都有实施，但可能导致过度治疗和不良的美容结果。MMS 常用于皮肤科手术治疗恶性病变，具有较高的治愈率，避免了过度切除组织，从而提高了患者满意度。
早期诊断和最小程度的切除可以成功治疗 EAN。MMS 比传统的全切除提供更好的美容效果。
