I saw this once about 5 years ago. I think I found a discussion of it in
the Lactnet Archives which helped me a lot in my new job as a
hospital-based LC. The dead skin seemed to slough off with baby's oral
mucous and gentle soaking with a warm moist (water or EBM) cloth. Nurses
didn't appreciate the little "floaters" in the pumped milk (baby was Level
II but did finally go to breast). By discharge, it was mostly gone, milk
supply was very good, and baby d/c'd with mom. Her nipples did appear large
enough to challenge baby, but baby persisted, the skin pieces came off, and
baby nursed more easily on the soft nipple skin underneath. I don't recall
that mom reported any nipple tenderness with this newly exposed skin.
Searched Google for 'keratosis' 'nipple' and Google Advanced for
'definition' 'keratosis'
Try this link:
http://www.thedoctorsdoctor.com/diseases/nevoid_hyperkeratosis.htm
Or this link:
http://www.ingentaconnect.com/content/bsc/ajd/1999/00000040/00000004/art0036
7
Bilateral nipple hyperkeratosis treated successfully with topical
isotretinoin
Authors: Toros P.; Önder M.; Gürer M.A.
Source: Australasian Journal of Dermatology, Volume 40, Number 4, November
1999, pp. 220-222(3)
Publisher: Blackwell Publishing
SUMMARY
A 22-year-old woman presented with bilateral thickening and
hyperpigmentation of her nipples since the age of 17 years. There was no
history of pregnancy or oral contraceptive pill use. Isotretinoin 0.025%
gel was applied twice daily and the lesions disappeared in 4 weeks. After
the drug was ceased, recurrence appeared within 4 months. The same therapy,
applied for 2 weeks, again cleared the problem.
Or this idea for a VERY permanent solution:
Surgical Treatment of Nevoid Hyperkeratosis of the Areola by Removal of the
Areola and Reconstruction With a Skin Graft. Annals of Plastic Surgery.
54(6):667-669, June 2005.
Milanovic, Rudolf MD, MSc; Martic, Kresimir MD; Stanec, Sanda MD, PhD; Zic,
Rado MD, PhD; Vlajcic, Zlatko MD; Stanec, Zdenko MD, PhD
Abstract:
Hyperkeratosis of the nipple and areola is a rare, sporadic, benign
condition characterized by verrucosus thickening and brownish discoloration
of the nipple and areola. Approximately 50 cases of hyperkeratosis of the
nipple and areola have been reported in the literature. Dermatologists
treated most of them conservatively. We have described the case of healthy
19-year-old girl with bilateral nevoid hyperkeratosis of the areola and our
treatment by surgical removal of the areola and reconstruction with a skin
graft. As far as we know, this is the first report of this kind of
treatment. The final result is esthetically excellent and without
recurrence during 12 months' follow-up.
(C) 2005 Lippincott Williams & Wilkins, Inc.
Phyllis Adamson, IBCLC, RLC
Glendale, AZ
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