Differential Diagnosis for Red Scaly Itchy Nipple
- Single most likely diagnosis
- Eczema (atopic dermatitis or contact dermatitis): This is the most common cause of a red, scaly, itchy nipple. Eczema can be triggered by various factors including allergies, irritants, or genetic predisposition.
- Other Likely diagnoses
- Psoriasis: Characterized by well-defined, red, scaly plaques, psoriasis can affect the nipple-areolar complex, leading to itching and discomfort.
- Seborrheic dermatitis: This condition causes a red, itchy, and flaky rash, often on oily areas of the body, including the nipple.
- Dermatitis caused by breastfeeding (nipple dermatitis): Irritation from breastfeeding can lead to redness, scaling, and itching of the nipple.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Paget's disease of the breast: A rare form of breast cancer that can present with eczema-like changes to the nipple, including redness, scaling, and itching. It is crucial to rule out this condition due to its potential for malignancy.
- Inflammatory breast cancer: Although rare, this aggressive form of breast cancer can cause skin changes, including redness and scaling, and must be considered in the differential diagnosis.
- Rare diagnoses
- Contact dermatitis due to allergy (e.g., to nickel in jewelry): While less common, an allergic reaction to certain metals can cause a red, scaly, itchy rash on the nipple.
- Lichen sclerosis: A rare condition that can cause thinning and scarring of the skin, leading to itching and discomfort in the affected area, including the nipple.
- Sarcoidosis: A systemic disease that can cause skin lesions, including on the nipple, though this is extremely rare.