Age: 63 year
Site: Areola and nipple of the breast
Duration: > one year
History: A persistent, moderately pruritic, unilateral, slightly infiltrative red plaque involved the left nipple and surrounding areolar region. The patient claimed partial improvement on topical steroid treatment which had been prescribed from time to time. O/E many left axillary lymph nodes were palpable. Skin biopsy confirmed the diagnosis of Paget's disease and immunohistochemical assessment revealed positive CEA, EMA and negative S-100 protein. The patient had been referred to surgery.