Differential Diagnosis for Small Areola Abruption like a Pimple

• Single most likely diagnosis:
  • Montgomery tubercles: These are small, bumps on the areola that can resemble pimples. They are a normal anatomical variation and become more pronounced during pregnancy due to hormonal changes.
• Other Likely diagnoses:
  • Acne: Given the description of the lesion resembling a pimple, acne could be a consideration, especially if the individual is prone to acne.
  • Folliculitis: An inflammation of the hair follicles, which could present as small, pimple-like lesions on the areola.
  • Ingrown hair: If the individual has hair on their areola, an ingrown hair could cause a small, pimple-like lesion.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Breast cancer: Although rare, any new lesion on the breast or areola should prompt consideration of breast cancer, especially if accompanied by other symptoms like nipple discharge, a lump, or changes in the size or shape of the breast.
  • Inflammatory breast cancer: A rare and aggressive form of breast cancer that can cause skin changes, including redness and pimple-like lesions.
  • Paget's disease of the breast: A rare form of breast cancer that affects the skin of the nipple and, sometimes, the areola, causing eczema-like changes, which might initially be mistaken for a pimple.
• Rare diagnoses:
  • Areolar abscess: A localized collection of pus in the areolar tissue, which could present as a painful, pimple-like lesion.
  • Hidradenitis suppurativa: A chronic skin condition that can cause painful, inflamed lesions in areas of the body with apocrine glands, including the areola, though this is less common.
  • Dermatitis: Various forms of dermatitis (contact, atopic, etc.) could potentially cause lesions on the areola that might resemble pimples.