Intended for healthcare professionals

Endgames Case Review

An ulcer on the nipple

BMJ 2018; 360 doi: (Published 11 January 2018) Cite this as: BMJ 2018;360:j5850
  1. Jianjun Qiao, consultant dermatologist,
  2. Sha Zhou, resident dermatologist,
  3. Hong Fang, professor of dermatology
  1. Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
  1. Correspondence to Hong Fang fanghongzy{at}

A 39 year old woman presented with an asymptomatic ulcer on her left nipple. The ulcer had been present for five weeks. She also reported malaise. She denied any travel history in the past three months, but recalled a history of breast bites and breast-genital contact during sexual intercourse, which had occurred two weeks before the skin lesion appeared. Physical examination revealed demarcated ulceration with a border that was slightly elevated, crusted, and indurated (fig 1). Left axillary lymphadenopathy was noted.

Fig 1

Demarcated ulceration with slightly elevated, crusted, and indurated border on the left nipple


  • 1. What are the clinical differential diagnoses of nipple ulceration?

  • 2. What investigations would be helpful to confirm the diagnosis?

  • 3. How …

View Full Text

Log in

Log in through your institution


* For online subscription