Dear Sir,

Accessory nipples are solitary or multiple rudimentary nipples developing along the two vertical 'milk-lines'. Most cases are sporadic and asymptomatic. Accessory nipple occurs in 1-6% of the population and affects both genders equally.¹1 Grossl NA. Supernumerary breast tissue: historical perspectives and clinical features. South Med J. 2000;93:29-32. It is often mistaken as dermatofibroma in clinical or dermatoscopic examination. Blum et al. have reported a case of accessory nipple indistinguishable from dermatofibroma, with dermatoscopic features such as peripheral pigment network and central scar-like white-colored area.²2 Blum A, Roehm S. Accessory nipple looks like dermatofibroma in dermoscopy. Arch Dermatol. 2003;139:948-9. Oztas and Gurer detected a cleft-like appearance in the dermatoscopic evaluation of four of their five patients.³3 Oztas MO, Gurer MA. Dermoscopic features of accessory nipples. Int J Dermatol. 2007;46:1067-8. Herein, we would like to point out the potential of portable digital microscopy for the diagnosis of accessory nipple in clinical practice. In our clinic, we use a Celestron handheld digital Microscope model #44301, at 30-fold magnification, provided with a focus ring and six LED ring illuminators. It has a resolution of 1280 x 1024 pixels and provides JPEG-format digital images, which are downloaded via USB connection to a personal computer.

A 30-year-old man presented with a congenital 4x5 mm brownish-pink nodule in his right subcostal region (Figure 1). We could not detect a cleft-like appearance in dermatoscopic evaluation. Dermatoscopic examination disclosed a dermatofibroma-like appearance with peripheral pigment network and a central scar-like area (Figure 2). However, the cleft-like appearance was observed in digital microscopy (Figure 3).

A portable digital microscope with 30- to 100-fold magnification is a more affordable imaging device than a dermatoscope and it can be helpful in the diagnosis of accessory nipple in clinical practice.

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