title: Red nodule on the breast.
abstract: A 63-year-old woman living in the countryside referred to our department with a 2-month history of a red nodule localized on the right breast. Histological examination, immunohistochemical analyses and serologic evaluation conducted with ELISA and Western blot were performed. Clinical diagnosis of borrelial lymphocytoma was not possible solely on the clinical presentation of a classical nodular form without lymphoadenopathy. An absence of a referred prior tick bite and a previous or concomitant erythema migrans at clinical presentation rendered a more challenging diagnosis. The fact that the patient lived in the countryside, the appearance of the breast nodule in September, and serologic, histologic, and immunohistochemical analysis facilitated the diagnosis of borrelial lymphocytoma. We report this case to highlight the importance of an investigation of Lyme borreliosis when a patient living in the countryside presents with a red nodule of the nipple and areola.
authors.affiliation: Division of Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Colucci
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Galeone
authors.forename: Meena
authors.initials: M
authors.lastname: Arunachalam
authors.forename: Samantha
authors.initials: S
authors.lastname: Berti
authors.forename: Cinzia
authors.initials: C
authors.lastname: Pinzi
authors.forename: Serena
authors.initials: S
authors.lastname: Bellandi
authors.forename: Silvia
authors.initials: S
authors.lastname: Moretti
keywords: Borrelial lymphocytoma; breast; cutaneous nodule