Differential Diagnosis for Hyperpigmentation Spots Under Breasts
Single Most Likely Diagnosis
- Intertrigo: This is the most likely diagnosis due to the location under the breasts, which is a common area for skin friction and moisture accumulation, leading to intertrigo. Intertrigo is a type of skin inflammation caused by friction, heat, and moisture, often resulting in hyperpigmentation.
Other Likely Diagnoses
- Eczema (atopic dermatitis): This condition can cause hyperpigmentation, especially in areas prone to friction and moisture like under the breasts. Eczema is characterized by itchy, inflamed skin, which can lead to post-inflammatory hyperpigmentation.
- Contact dermatitis: Irritant or allergic contact dermatitis can occur under the breasts due to friction, soap, or other irritants, leading to hyperpigmentation.
- Acne inversa (hidradenitis suppurativa): Although more commonly associated with the axillae, groin, and buttocks, acne inversa can occur under the breasts, leading to hyperpigmented lesions.
Do Not Miss Diagnoses
- Breast cancer: Although rare, breast cancer can manifest as skin changes, including hyperpigmentation, under the breast. Inflammatory breast cancer, for example, can cause skin changes such as redness, swelling, and hyperpigmentation.
- Lymphoma: Cutaneous T-cell lymphoma (mycosis fungoides) can present with hyperpigmented patches, and although rare, it is crucial not to miss this diagnosis.
Rare Diagnoses
- Addison's disease: This rare endocrine disorder can cause diffuse hyperpigmentation, including under the breasts, due to increased ACTH levels.
- Hemochromatosis: This genetic disorder leads to iron overload, which can cause skin hyperpigmentation, among other symptoms.
- Mastocytosis: A rare condition characterized by an accumulation of mast cells in the skin, which can lead to hyperpigmented lesions.