could it be pagets?

[marieburger]

i have a dry scaley rash directly next to the areola on the left breast.  i have had itching in that breast especially the nipple for nearly a year and the rash for 6 months.  the rash does not respond to any of the creams prescribed.  the area also looks bruised underneath.  No nipple discharge, just rash and itching.  Does pagets only affect the nipple and areola or can it show up on the breast?

[Dennis MD]

Hi there.
Paget’s disease involves the nipple during the early stages, and then later involves the areola or underlying breast.  It is typically characterized as crusting, redness, irritation, eczematoid changes, discharge, and nipple inversion.  Mammography should be carried out, with special attention to the area underneath the nipple.  Pathologic examination should reveal the presence of Paget’s cells within the epidermis of the nipple.
However, there are also other conditions that can present with rash and itching of the nipple.  A local infection is an example.
I would suggest having yourself seen by your doctor for further evaluation and management.  
Good luck.

[marieburger]

thank you for your reply, i have seen the doc who seems concerned about the area and has also found a lump (not quite sure where though!)  good news though he has referred me to the breast clinic which i have managed to get an appointment for tomorrow.  fingers crossed eh.