Section: Breast Curriculum: Curriculum, page 10
Definition
- Atopic dermatitis affecting the breast / nipple-areolar region
Incidence
- Most frequent at the areola of pregnant and breast-feeding women
Aetiology
- Atopy
- Irritant contact dermatitis (soap, bra material)
- Associated with infant teething or introduction of solids
Clinical
- Hx: Burning pain / itchy
- Onset of Sx most commonly occurs at 5-6 months post-partum
- Well demarcated erythematous rash – usually bilateral
- Dry or weeping
- Papules, vesicles, crusts, erosions, oozing, lichenification, excoriation
Pathology
- Secondary bacterial infection is common
Investigations
- In pts > 40: Rule out Paget’s / Inflammatory Cancer
- Punch biopsy +/- excision biopsy
Management
- Avoid soap
- Aqueous cream as a soap substitute
- Pine Tarsol Solution (500mL) in bath / 5 mL in bowl of water and soak
- Locoid cream (100g tube) bd → regularly for 2/52 then prn
- 10/7 po co-trimoxazole
- Fucidin gel – apply to any new infected areas which develop
Comparison with Paget’s disease of the nipple
