---
title: A 58-year-old woman presents with burning, itching, and scaling skin around her areola
description: It's Medical Oncology Quiz Time with Med-Challenger!
---

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# [A 58-year-old woman presents with burning, itching, and scaling skin around her areola](https://challengercme.com/blog/a-58-year-old-woman-presents-with-burning-itching-and-scaling-skin-around-her-areola)

 Written by [Med-Challenger](https://challengercme.com/blog/author/med-challenger) | Jan 20, 2025 3:49:17 PM

A 58-year-old woman presents with a 1-month history of burning, itching, and scaling skin around her right areola. This presentation appears similar to contact dermatitis or eczema, and you prescribe a trial of 1% hydrocortisone ointment and recommend that she follow-up with you in 2 weeks.

On her return visit, there has been no significant improvement. In addition to mammography, the next diagnostic step would include which of the following?

- referral to a breast surgeon for possible small excisional biopsy of areolar tissue to rule out lobular carcinoma in situ
- course of empiric antibiotics to treat a superimposed infectious component
- referral to a breast surgeon for possible small excisional biopsy of areolar tissue to rule out Paget disease and associated ductal carcinoma in situ
- referral to a breast surgeon for possible small excision of the involved duct to rule out duct ectasia

 

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