Dermatoses of the breast in lactation

Abstract

Dermatoses of the breast during lactation can be difficult to diagnose because of their overlapping clinical appearances. It is important to properly diagnose and treat nipple dermatitis since it can be a significant source of pain when nursing. Poorly controlled nipple pain in nursing mothers is one of the primary reasons for breastfeeding to be discontinued earlier than is recommended. Therefore, it is relevant for practicing dermatologists to be aware of certain facts in a patient's history, specific physical exam findings, and the most appropriate laboratory tests used to diagnose these conditions. In addition, the therapeutic approach should be effective and safe for the mother and infant. This review article provides dermatologists with a detailed discussion on the clinical features and management of various breast dermatoses seen in lactation, including atopic dermatitis, irritant contact dermatitis, allergic contact dermatitis, psoriasis, bacterial infections, yeast infections and herpes simplex virus infections.

Mammary candidiasis: A medical condition without scientific evidence?

“…albicans could be isolated from breast milk and misdiagnosed as the cause of mastitis. As a consequence, mothers whose infants suffer oral candidiasis should not receive antifungal therapy, despite it is a regular practice [34]. …”

An unusual localised pigmented skin lesion on the nipple-areola complex

“…Histopathological features of eczematous conditions include hyperkeratosis, parakeratosis, acanthosis, and increased melanin in the epidermis basal layer 1. In pigmented seborrheic keratosis, hyperkeratosis and horn cysts are present, which are clearly demarcated from adjacent skin 2.…”

“…In contact dermatitis and eczema, hyperpigmentation appears in the chronic phase 1. In seborrheic keratosis, hyperkeratosis and horn cysts are present.…”

“…Generally, these diseases have similar pigmented manifestations, but in eczematous conditions, such as contact dermatitis and eczema, hyperpigmentation appears in the chronic phase 1. The hypertrophic scaly dark red patches with lichenification and pigmentation are the typical manifestations, and history for allergic reaction is helpful for diagnosis.…”

ABM Clinical Protocol #26: Persistent Pain with Breastfeeding

“…Bacterial overgrowth combined with biofilm formed by bacteria (possibly in conjunction with Candida sp) may lead to narrowed lactiferous ducts and inflamed 18,20 Reduce identifiable triggers. Apply an emollient.…”