Unilateral Hyperkeratosis of the Nipple: The Response to Cryotherapy

To the Editor.— Hyperkeratosis of the nipple and areola is a rare condition that may have nevoid features, resemble acanthosis nigricans, or be associated with ichthyosis.1,2It is of cosmetic importance only, but a lack of response to topical therapy or treatment with retinoids3may lead patients to seek surgery.2 Report of a Case.— A 30-year-old woman presented with a three-year history of warty distortion of her left nipple and areola that started just after the birth of her son. The right nipple was normal, the lesion was asymptomatic, and she was otherwise well. She gave no personal or family history of warts, epidermal nevi, or ichthyosis. Examination revealed warty hyperkeratosis confined to the left nipple and areola (Fig 1), but no other abnormality. Histologic examination of the lesion confirmed the clinical diagnosis of nevoid hyperkeratosis of the nipple. Restriction enzyme analysis was performed, but no