Abstract
When faced with eczematous lesions involving the nipple–areolar complex (NAC), Paget's
disease is assumed to be the diagnosis, anything else being considered a “Zebra” necessitating
its exclusion on pathology. A middle-aged lady presented with synchronous asymmetrical
ulceration of bilateral NAC with pleomorphic calcifications on mammography and simultaneous
extensive vascular calcification in bilateral breasts that suggested systemic cause.
Calciphylaxis is a rare diagnosis occurring usually due to underlying end-stage renal
disease or hyperparathyroidism. There are very few case reports of calciphylaxis due
to alcoholic liver disease and no cases to the best of our knowledge involving NAC.
We report an extremely rare case of breast and NAC calciphylaxis due to alcoholic
liver disease, highlighting need to consider benign etiology when bilateral involvement
is present.
Keywords
breast - calciphylaxis - nipple–areolar complex - Paget's disease
