A Pruritic Rash

Members of the College of Family Physicians of Canada may claim one non-certified credit per hour for this non-certified educational program.

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Francesca Cheung, MD CCFP, is a family physician with a special interest in dermatology. She received the Diploma in Practical Dermatology from the Department of Dermatology at Cardiff University in Wales, UK. She is practising at the Lynde Centre for Dermatology in Markham, Ontario and works closely with Dr. Charles Lynde, MD FRCPC, an experienced dermatologist. In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne.

Mammary Paget disease (PD) is a less common form of breast cancer which involves the nipple-areola complex and occurs almost exclusively in females. Erythema, skin thickening, pruritus, burning sensation, inversion of the nipple, ulceration, serosanguineous nipple discharge are common clinical symptoms. Approximately 1-4% of female breast carcinoma are associated with PD of the nipple-areola complex. A biopsy including the dermal and subcutaneous tissue should be performed on all suspicious lesions of the nipple-areola complex for accurate diagnosis. The first line treatment of mammary PD is mastectomy (radical or modified) and lymph node clearance for patients with a palpable mass and underlying invasive breast carcinoma. The prognosis of mammary PD is determined by the disease stage and is similar to that of other types of breast cancer.
Key Words: Mammary Paget disease, breast cancer, nipple-areola complex, metastasis.