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Unilateral nipple erosion with acantholysis

A woman in her 40s sought treatment for a painless erosion over the left nipple of 6 months duration. There was no history of oral or genital ulcers, skin blisters, and lesional trauma. The erosion had partially responded to topical steroids but recurred on its discontinuation. On physical examination, a 3 9 3 cm erosion was noted on the left nipple and areola (Fig. 1). The erosion had well-defined, regular margins, and the floor was covered by pink granulation tissue. Clinical examination did not reveal any breast mass or axillary and cervical lymphadenopathy. Examination of the oral cavity, genitalia, and scalp was within normal limits.