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Zuska disease, also known as Zuska-Atkins disease, is a rare pathology that is characterized by recurrent subareolar abscess formation, sometimes followed by fistula and pus drainage.
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It is seen more commonly in females however, case reports of male disease have also been reported in literature 1.
Zuska disease is usually seen in cigarette smokers. In the literature, the disease has three reported stages. In the earlier stages, squamous metaplasia, as well as blockage, and plugging of lactiferous ducts are identified. These processes result in pus and debris formation. In the third stage, there is periareolar fistula formation and discharge of pus from the fistula.
Treatment and prognosis
Excision of the fistula and the lactiferous ducts is endorsed to prevent recurrent episodes.
A few of the differential diagnoses of Zuska disease include:
- inflammatory carcinoma
- atypical infection
History and etymology
In 1951 Joseph J Zuska et al. published a case series on patients with fistulas of their lactiferous ducts in which he included pathological findings and suggested duct plugging was part of the etiology 3.
- 1. Serrano LF, Rojas-Rojas MM, Machado FA. Zuska's breast disease: Breast imaging findings and histopathologic overview. (2020) The Indian journal of radiology & imaging. 30 (3): 327-333. doi:10.4103/ijri.IJRI_207_20 - Pubmed
- 2. Johnson SP, Kaoutzanis C, Schaub GA. Male Zuska's disease. (2014) BMJ case reports. doi:10.1136/bcr-2013-201922 - Pubmed
- 3. ZUSKA JJ, CRILE G Jr, AYRES WW. Fistulas of lactifierous ducts. Am J Surg. 1951 Mar;81(3):312-7. PMID: 14819475. doi:10.1016/0002-9610(51)90233-4 Pubmed