There is a small fleshy pimple on the areola

Many breastfeeding mothers will develop small bumps on their areola, which usually do not itch or hurt. After feeding, the baby will feel itchy and the area around the areola will become dry and flaky. This condition is usually considered nipple eczema. It is a very common skin disease. Apply some topical ointment in time. Do not use too hot water or rub hard with a bath towel when taking a bath. It will get better slowly. Let’s take a look at the clinical manifestations and diagnosis of nipple eczema.

1. Clinical manifestations

Breast eczema often occurs on the nipple, areola and their surrounding areas. It has clear boundaries, the lesions are brown-red, and there is obvious erosion. It is covered with scales or thin scabs, and cracks may occur when there is infiltration. The patient feels itching and pain. Eczema is divided into three types according to the manifestation of skin lesions: acute, subacute and chronic.

1. Acute eczema

The rash is composed of numerous densely packed millet-sized papules, papulovesicles or vesicles with a flushed base. Due to scratching, the skin lesions may show obvious punctate exudation and small erosions. The center of the lesion is often heavier and gradually spreads to the surrounding area. There are also scattered papules and papulovesicles on the periphery, so the boundaries are unclear. When combined with infection, the inflammation may be more obvious and form pustules, pus oozing out or yellow-green or dirty brown scabs. It may also be combined with folliculitis, furuncle, local lymphadenitis, etc.

2. Subacute eczema

Subacute eczema occurs when the inflammation of acute eczema is alleviated, or if the acute phase is not promptly and appropriately treated and is delayed for a long time. The skin lesions are mainly small papules, scales and crusts, with only a few papulovesicles or small blisters and erosions. There may also be mild infiltration, and the patient still feels severe itching.

3. Chronic eczema

It is mostly caused by repeated attacks of acute or subacute eczema, or it may present as chronic inflammation from the beginning. The skin of the affected area is infiltrated and thickened, turning dark red and pigmented, with a rough surface and covered with a small amount of bran-like scales, or scabs due to scratching. Some cases have varying degrees of lichenification, which is localized and has clear edges. There may also be scattered papules and papulovesicles on the periphery. During acute attacks, there may be obvious exudate. The subjective symptoms also include obvious itching, which often occurs in paroxysms. The course of the disease is uncertain, prone to relapse, and difficult to heal.

Whether acute, subacute or chronic eczema, the course of the disease is uncertain, it is easy to relapse, it can transform into each other and it is difficult to heal for a long time. Conscious itching. Drinking, scratching, using soapy water, scalding with hot water, etc. can aggravate skin lesions and increase itching, and in severe cases can affect sleep.

2. Differential Diagnosis

It must be differentiated from eczematoid carcinoma of the breast. The latter occurs at an older age, most commonly around the age of 50. Sudden eczema-like changes in the breast may occur, with even ulcer formation and nipple ulceration or disappearance. In the later stages, breast lumps, nipple discharge, or other changes may occur. Examination of local skin exfoliated cells or prints, or examination of scraped skin tissue from a portion of the affected skin can aid in diagnosis. Incisional biopsy is most diagnostic