A 72-year-old man presented with a one year progressive growing lesion located on the right nipple. He was asymptomatic. A round plaque occupying all nipple and areola was observed. The plaque presented with ragged edges protruding from the areola, had heterogeneous pigmentation, was indurated and adhered to deep planes. Dermoscopy showed telangiectasia, pseudopods and areas suggestive of regression (Fig. 1). The differential diagnosis included melanoma, breast cancer and pigmented basal cell carcinoma. An incisional biopsy was performed. Histology confirmed the diagnosis of ductal breast carcinoma (Fig. 2).
Breast carcinoma is an infrequent condition among males. The average age of diagnosis is 60–65 years. In up to 25% cutaneous involvement is the first manifestation. Despite similar prognosis between sexes at the same stage, a lower survival rate in males is accounted by late diagnosis. This image shows an atypical cutaneous presentation of breast carcinoma mimicking melanoma.
