Differential Diagnosis for Chronic Itchy Nipples
Single Most Likely Diagnosis
- Eczema/Dermatitis: This is the most common cause of itchy nipples, often due to irritants, allergens, or atopic predisposition. The chronic nature of the itch and the localized area make eczema a highly plausible diagnosis.
Other Likely Diagnoses
- Psoriasis: Can cause itchy, scaly patches on the nipples, among other areas. The presence of similar lesions elsewhere on the body would support this diagnosis.
- P Paget's Disease of the Nipple: A rare form of breast cancer, but when considering chronic itch, it's a possibility, especially if accompanied by other symptoms like nipple discharge or a rash.
- Allergic Contact Dermatitis: An allergic reaction to substances like nickel (in jewelry), certain soaps, or lotions can cause itchy nipples.
Do Not Miss Diagnoses
- Inflammatory Breast Cancer: Although rare, this aggressive form of breast cancer can present with itching, redness, and swelling of the breast, including the nipple area. Early detection is crucial.
- Nipple Adenoma or Intratductal Papilloma: Benign tumors that can cause itching, discharge, or a lump near the nipple. While not typically life-threatening, they can be concerning and require proper evaluation.
Rare Diagnoses
- Sarcoidosis: A systemic disease that can cause skin lesions, including on the nipples, and can be itchy. Diagnosis is often made after other systemic symptoms are identified.
- Lichen Sclerosus: A chronic inflammatory skin condition that can affect the genital and nipple areas, causing itching and scarring. It's rare but should be considered in persistent cases without other clear causes.