A 46-year-old woman with no personal or family history of cancer presented to the Department of Dermatology at the Complejo Hospitalario Universitario de Granada, Granada, Spain, in 2017 with an eczematous plaque in the areola of the left breast. The plaque had developed over the course of the past four years and was associated with stinging, itching and occasional suppuration. She had been previously treated with topical corticosteroids and antibiotics without improvement. A mammogram performed the previous year showed a small benign nodule of 8 x 5 mm in diameter and a simple cyst of 5 mm in diameter in the right breast. There was no evidence of ductal ectasia or alterations at the left retroareolar level l. A physical examination revealed an erythematous-squamous plaque of 4 x 5 cm in diameter on the left breast without infiltration and with effacement of the areola-nipple complex [ Figure 1].No local lymph nodes were palpated. A cutaneous ultrasound showed hyperkeratosis of the epidermis with a hypoechoic area in the dermis with increased vascularisation. A large incisional biopsy confirmed a diagnosis of Paget's disease of the nipple with ductal carcinoma in situ. A quadrantectomy and selective sentinel node biopsy were performed, the latter of which was negative. The patient was subsequently monitored for the next three years without evidence of clinical recurrence. CommentPaget's disease of the breast is characterised by the intraepidermal infiltration of malignant glandular interesting medical image Sultan Qaboos University Med J, November 2017, Vol. 17, Iss. 4, pp. e487-488,

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