54 Letters to the Editor defines the best suited body site for clinical studies as the volar surface of the foreami. the upper arm and the cheek (Table 1). When interindividual stud- ies are performed on areas with a low Qi the number of volunteers must be increased in order to obtain significant results [1,7]. Florian Kautzky ', Michael W. Dahm, Lars D. Kiihler, Michael Drosner. Hermann-J. Vogt, Siegfried Borelli Department of Dermatology. Technisclie Uniiersitlii Munchen. Biedersteiner Strafie 29. 80802 Munchen. Gemuinv ' Corresponding author. Tel.: (089) 38493177; Fax: (089) 38493127. PII S0926-9959(96)00078-5 [I] Kauizky F, Dahm M. Drosner M, Kohler. LD. Vogi HJ, Borelli S. Direct profilometry of the skin: it's reproducibility and variability. J Eur Acad Dennatol Venereol 1995;5:15-23. [2] Linde YW. Bengtsson A, Loden M, 'Dry' skin in atopic dermatitis. II. A surface protHometry sttjdy. Acta Derm Venereol (Stockh) 1989;69:.1I5-319. [3] Heinrich U, Tronnier H. Die Hautoberflachen-Stmkturanalyse. TW Dermaiologie 1991;21:54-61. [4] Makki S, Barbenel JC, Agache P. A quantitative method for the assessment of the microlopography ot" human skin. Acta Derm Venereol (Stockh) 1979;59:285-291. [5] Caputo R, Monti M, Motta S, Barbareschi M, Tosti A. Serri R, Rigoni C. The treatment of visible signs of senescence: the Italian experience. Br J Dermatoi 1990:l22(Suppl 35):97-103. [6] Koning HC. Kerscher M. Vieluf D. Mehringer L, Megele M, Braun-Faico, O. Commercial glucocorticoid formulations and skin dryness. Could it be caused by the vehicle? Acta Derm Venereol (StcK-kh) 199l;7l:2f)l-2f)3. [7] Machin D, Ciunpbell MJ. Statistical tables for the Design of Clinical Trials. Blackwell Scientific Publication, Oxford 1987:79-88. ]VIaIe breast cancer with skin invasion To the Editor: A 62-year-old man attended our out-patient c]inic presenting an ulcer on his left mammary areo]a. History revealed that he had no- ticed a nodule 7 years ago, but at that time did not receive any therapy. Dermatologica] examination ev- idenced an u]cerated, crusted nodular lesion with infi]tration into the underlying tissues (Fig. 1). Lymhadenopathy was palpabie in the ]eft axillary region. Routine biochemical studies and hormone profile (estradiol, testosterol. prolactin) were within normal limits. Prostate cancer markers PAP. PSA and CEA, were a]so normal. Mammary ultrasonogra- phy revealed a heterogenous mass of 1.3 X 0.8 cm diameter localized in the left areolar area. Thorax CT showed a soft tissue mass 2.5 cm in size on the chest wall and nodal density between the lesion and pec- toral muscle. MRI demonstrated an irreguiariy shaped, heterogenous mass infiltrating the pectoral muscle. Under the site of the skin lesions an expand- ing tumor image was apparent. Total body scan and abdomina] u]trasonography showed no pathological signs. Histopathology revealed poorly formed tubules and clusters of pleomorphic tumor cells. Lympho- Fig. I. Crusted lesion on the areola.