LAUSR

EJD, vol. 31, n◦ 4, July-August 2021 suggests that retrograde spread of the virus from a primary nipple condyloma is possible. The spread may also be due to leakage of HPV to the blood circulation from a primary infected site [4, 5]. In case of clinical suspicion of associated malignancy, breast ultrasound examination or MRI should be performed, especially in women. In our patient, the absence of relevant history and clinical atypia did not prompt additional investigations. However, close follow-up is recommended in order to detect associated skin malignancies due to comorbidities on the one hand, and to treat recurrences on the other.