Document Detail

Pregnancy-associated hyperkeratosis of the nipple: a report of 25 cases.
MedLine Citation:
PMID:  23616176     Owner:  NLM     Status:  MEDLINE    
IMPORTANCE: Reported physiologic nipple changes in pregnancy do not include hyperkeratosis and are expected to resolve or improve post partum. Hyperkeratosis of the nipple and/or areola can develop in the context of inflammatory diseases (such as atopic dermatitis), in acanthosis nigricans, as an extension of epidermal nevus, after estrogen treatment, and/or in nevoid hyperkeratosis of the nipple and areola. We performed a clinicopathologic analysis of cases of pregnancy-associated nipple hyperkeratosis.
OBSERVATIONS: Twenty-five cases of pregnancy-associated nipple hyperkeratosis identified during a 5-year period (January 1, 2007, through December 31, 2012) are reported. The lesions were bilateral and involved predominantly the top of the nipple. Lesions were symptomatic in 17 patients (68%), causing tenderness or discomfort, pruritus, sensitivity to touch, and/or discomfort with breastfeeding. Nine patients (36%) experienced symptomatic aggravation only during pregnancy or breastfeeding. The lesions persisted post partum in 22 patients (88%). Histopathologic features were conspicuous orthokeratotic hyperkeratosis, with papillomatosis and acanthosis being mild or absent.
CONCLUSIONS AND RELEVANCE: Pregnancy-associated hyperkeratosis of the nipple can be symptomatic and persist post partum. It may represent a physiologic change of pregnancy. The characteristic clinicopathologic features of this disorder allow differentiation from nevoid hyperkeratosis of the nipple and areola. We suggest that this distinctive clinicopathologic entity be called pregnancy-associated hyperkeratosis of the nipple.
H William Higgins; Jennifer Jenkins; Thomas D Horn; George Kroumpouzos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JAMA dermatology     Volume:  149     ISSN:  2168-6084     ISO Abbreviation:  JAMA Dermatol     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-06-20     Completed Date:  2013-09-02     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  101589530     Medline TA:  JAMA Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  722-6     Citation Subset:  AIM; IM    
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MeSH Terms
Breast Diseases / pathology*
Keratosis / pathology*
Nipples / pathology*
Pregnancy Complications / pathology*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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