On Wed, 15 Jun 2005 22:20:16 -0500, Kathy <[log in to unmask]> wrote:

>I cannot come to terms with a physiologic reason why skin would "grow over"
>the nipple pore.  I agree that an "old", recurrent bleb can start to look
>like that, but I can't believe that is the initial mechanism that gets it
>all started.

Me too -- anatomically it just does not make sense.  However, I have now 3
times inadvertantly pulled up suction blisters on the tip of one nipple.
Sizable things, at least 5-6mm in diameter, with the entire area raised.
What I can't figure out is how this covers 2 nipple pores, which it visibly
does as the blisters quickly fill with milk and produce that exquisitely
torturous form of pain.  This would seem to indicate that the skin is
somehow continuous across the pores in the first place, which is obviously
not the case.  If I make a large enough hole in the skin to allow it to
drain, the opening allows milk to exit and the excess skin just gradually
comes off painlessly without any further problems.  I was always able to get
these cleared very quickly, without the duct "backing up" at all, but I just
cannot figure out *how* these happen -- would think the blister edge would
stop at a pore or continue down inside it rather than somehow go across.

I did deal with a "chronic bleb" for a couple months that looked and acted
totally different than these blisters.  It was like there was a thick solid
yellowish/white plug with the surrounding area inflamed -- milk would
usually exit but every week or two it would get blocked and start throbbing,
one or two of the ducts would get ropy and painful, and I'd have to gently
scrape it a little to open things up a bit.  But since the plug was solid
and appeared to be several mm thick, I couldn't really see exactly what was
going on.  When it first showed up my LC suggested I have the breast surgeon
try to open it up completely for me, but I was too chicken -- I'd rather
wield the sharp instruments myself on that area of my body. :)  It
eventually just completely cleared on its own and that area looks pretty
much the same as the rest of the nipple.

I figured that what most likely caused it was that a little bit of excess
skin (common for full-time pumpers to have this shaggy/shedding nipple skin)
got caught in the pore and since I was often going 6-8 hours between pumps,
it was enough time for it to start an inflammatory reaction.

>I wish someone would biopsy these and tell us what is REALLY going on!!
>

No way would I have let someone biopsy it, especially just in the name of
scientific curiosity -- OUCH!  If I ever get something similar again, I
*might* consider letting the surgeon dig it out right at the outset and send
it to path, though I imagine it would just be a collection of old skin
cells, some dried milk, and general inflammation...

Sarah Reece-Stremtan M.D.
Washington D.C.

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