Itchy scaly nipple

Instructions

You are a medical student on placement in general practice in Bayswater. Your next patient is Fotini Lambrou, 64, presenting with an itchy right nipple that has left spots of blood on her bra and has not settled with a cream.

1. 1

   Take a focused history

2. 2

   Perform a focused examination

3. 3

   Outline to the examiner:

   • Your most likely diagnosis and differentials
   • Next steps in management, including relevant investigations

• You do not need to summarise your findings
• The breast examination is performed on a model; please verbalise it, and findings will be provided on request