While doing a prenatal visit recently, I encountered an unusual looking
nipple and was wondering if anyone had seen anything like it.

At the tip of the nipple was a cluster of tiny berry-like nodules, about
12-15 of them in total, each less than one mm in diameter, but definitely
raised above the skin surface.  They were a darkish-yellow.  At first I
thought it was dried colostrum, but they did not wipe away with a wet cloth.
Mother reported no discomfort until they were wiped, at which time they were
"tender".  The other side had a smaller, similar, but flatter growth.  Both
sites appeared at some point during the third trimester; mom was unsure of
exact timing.  I was unable to express any colostrum using manual expression.

I referred the mom to her OB/GYN for assessment and suggested she ask for a
referral to a dermatologist if he was unsure.  OB told her not to worry, but
"he would check around with his colleagues and call her next week" anyway.

Any views as to what this might be?

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