Differential Diagnosis for Nipple Peeling in an Adolescent

Single Most Likely Diagnosis

• Eczema/Dermatitis: This is a common condition in adolescents that can cause skin peeling, including around the nipple area. It's often related to allergic reactions or irritants.

Other Likely Diagnoses

• Contact Dermatitis: Similar to eczema, but specifically caused by an allergic reaction or irritation from something that has come into contact with the skin, such as certain fabrics, soaps, or lotions.
• Seborrheic Dermatitis: A condition that can cause scaly patches, red skin, and stubborn dandruff, and can also affect the nipple area, leading to peeling.
• Atopic Dermatitis: Part of a group of conditions that include eczema, characterized by itchy, inflamed skin that can peel, including around the nipples.

Do Not Miss Diagnoses

• Paget's Disease of the Breast: A rare form of breast cancer that can cause skin changes, including peeling around the nipple. Although rare, it's critical to rule out due to its serious implications.
• Infectious Diseases (e.g., Impetigo, Ringworm): Certain infections can cause skin peeling and must be considered, especially if there are signs of infection like redness, pus, or fever.

Rare Diagnoses

• Nipple Adenoma: A rare, benign tumor of the nipple that can cause skin changes, including peeling.
• Darier's Disease: A rare genetic disorder that affects the skin, causing signs that can include peeling, especially in areas like the nipples.
• Keratosis Pilaris: A condition that causes rough patches and small, acne-like bumps on the skin, which can sometimes appear around the nipples and cause peeling.