Hi,
I have a Mom at one month postpartum with an abnormal nipple wound. She had a crack at 1 wk pp, saw a different IBCLC who sent for tt revision. At 2 weeks she experienced symptoms of mastitis, called her midwife who prescribed abx without asking her to come in. Crack was still there. She came to see me today at 4 weeks because she is still experiencing the discomfort and is worried about recurrence of mastitis. It is not a crack! This is a round, 2cm circle at the base of the nipple in the fold, skin has sealed around the edges of the wound and the lower level of skin is visible. Looks like a crater, only thing I can compare it to is the scars some people have from picking pimples during puberty. It was moist and shiny, but that may be because she has been applying APNO. No redness, blood, scabbing, discharge. It still hurts her for a few seconds at the beginning of the feeding but is tolerable, but she is extremely nervous about recurring mastitis. 
Sorry if my description is less than perfect...

1- Has anyone ever seen something like this? Any tips?

2- My instinct is to send her to a dermatologist to make sure that the wound is not problematic. It does not look like it will seal any more at this point and I want to make sure that it's normal and won't cause more problems. Can anyone recommend a dermatologist with breast experience or a breast specialist with dermatology knowledge in NYC? (Queens, Manhattan, or Brooklyn preferable)

Thanks so much for any help!
Adina Lerer, RN, IBCLC 
Director of Lactation Services
Brooklyn Birthing Center

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