Therapeutische Besonderheiten bei Erkrankungen der Mamillenhaut

The nipple is the focal point of the human breast and serves important physiological, sexual, and aesthetic purposes. It can be affected by atopic, irritant, and allergic contact eczema, which often reduce the patient's quality of life. The objective of this article is to discuss the different types of nipple eczema and highlight relevant differential diagnoses and treatment options. A systematic search of PubMed was conducted to identify and critically appraise the existing literature on the topic. All articles on nipple eczema were considered eligible, regardless of publication date, language or study design. A final of 33 manuscripts on nipple eczema remained. The scarce literature and the limited number of high-quality manuscripts impedes provision of structured data on nipple eczema. To securely reach the educative value of this manuscript, the systematic review was combined with a manual databank search and selected manual search of textbooks. The differential diagnosis of nipple eczema encompasses among others nipple psoriasis, nipple candidiasis and Paget's disease. In case of diagnostic uncertainty, swabs or biopsies are indicated. Treatment of nipple eczema needs to rapidly control the signs and symptoms of the disease, since it can have a negative effect on quality of life and can lead to premature arrest of breastfeeding. The key treatment step is starting with topical corticosteroids or calcineurin inhibitors, both of which are considered safe during lactation. Avoidance of provoking factors, such as repetitive friction, chemical agents, or allergens, can help. The use of nipple protection devices can be proposed for nursing women and sometimes adjusting of latch/suck positioning during breastfeeding is needed. Furthermore, patients should be advised to moisturize the nipple intensively and to switch to emollient wash products. Warm water compresses, black tea compresses or commercially available tannin containing topicals can provide comfort.

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“…Scabies can affect the breast and nipple. Often symmetrical pruritic lesions will be seen on other parts of the body as well 68 …”

Section: Differential Diagnosismentioning

confidence: 99%

Nipple eczema: A systematic review and practical recommendations

Reynaert

Gutermuth

Wollenberg

2023

Acad Dermatol Venereol

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“…25% der Morbus-Paget-Fälle können auf ein in der Bildgebung okkultes DCIS zurückgeführt werden [6]. Ein Morbus Paget kann sogar in seltenen Fällen (13,7%) als isolierter Typ ohne Nachweis von DCIS oder invasivem Karzinom vorliegen und wird als Morbus Paget der Mamille vom extramammären Typ beschrieben [7].…”

unclassified

Differentialdiagnose: Borrelien-Lymphozytom

Plavic-Radeka,

Schmid,

Kägi

2024

Swiss Med Forum

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“…25% des cas de maladie de Paget peuvent être attribués à un carcinome in situ occulte à l'imagerie [6]. Dans de rares cas de maladie de Paget (13,7%), il peut même s'agir d'un type isolé, sans mise en évidence d'un CCIS ou d'un carcinome invasif; cette entité est décrite comme une maladie de Paget du mamelon de type extra-mammaire [7].…”

unclassified