Mammary Paget’s disease (MPD) is a rare form of intraepithelial adenocarcinoma occurring in the apocrine gland-bearing areas in patients older than 50 years old. This clinical disease presents as erythematous, scaly plaque that usually affects the unilateral nipple or areola and is frequently misdiagnosed as inflammatory or infectious dermatitis. In this report, we are presented with a 54-year-old Filipino female who came in with a 3-year history of persistent pruritic erythematous moist plaque on the right nipple gradually spreading to the surrounding areola previously treated as a case of fungal infection. Mammography revealed BI-RADS 4C. Skin punch biopsy showed nuclear atypia with pale staining cytoplasm and were consistent with MPD. Immunohistochemical stains showed positive for epithelial membrane antigen and carcinoembryonic antigen. We reiterate the importance of early diagnosis for appropriate treatment to prevent unwanted sequelae.