What Is Under My Breast?


Robert A. Norman, DO, MPH • Cory Porteus

Dr. Norman is in private practice in Tampa, FL. He is also associate professor, University of Central Florida School of Medicine, Orlando, and at Nova Southeastern School of Medicine, Davie, FL. Mr. Porteus is a third-year student of osteopathic medicine at Lake Erie College of Osteopathic Medicine, Bradenton, FL.

A 68-year-old woman presented with a 6-week history of a persistent rash that had appeared simultaneously beneath both breasts. She described the rash as feeling moderately itchy and stated that it had not spread beyond the submammary folds. She had a history of type 2 diabetes and hypertension, for which she was taking metformin and lisinopril, respectively. She was treating her rash with an over-the-counter topical cream and powder, but received no relief in symptoms. Recent blood tests were reviewed and appeared to be within the normal limits.

rashes, breasts, erythematous, candidiasis, satellite lesionsUpon examination, the rashes were erythematous and scaly with satellite lesions (Figures).They were present beneath each breast and extended no further than the skin covered by the overhanging appendages. We took a scraping and biopsy, and we asked her to return for a follow-up appointment in 2 weeks.




Based on the photographs and the case description, what is your diagnosis? 


A. Candidiasis              C. Allergic contact dermatitis

B. Inverse psoriasis     D. Intertrigo

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