Login

Nipple retraction and rashes

There are many women whose nipples have always been pulled in, in others pulling in of the nipple happens from time to time and lasts for a few minutes only.

 

Patients only require referral if the nipple retraction is new and persistent, or associated with other symptoms, such as an underlying lump, or blood-stained discharge.

 

 

Rash or eczema of the nipple

 

Persistent itchy rash around the nipple – areolar complexis usually a simple rash that happens to be on the breast rather than related to an underlying breast cancer.
 

Non-itchy rash - referral advised whether involving nipple or not

 

Additional symptoms indicating the need for immediate referral include:

  • Associated lump
  • Ulceration
  • Skin distortion
  • Unilateral nipple discharge

 

If these are absent, initial Primary Care management includes:

  • Regular application of topical steroid for at least 2 weeks and review response. The topical steroid should be placed under an adhesive dressing to be effective, and applied twice a day for 2 weeks.
  • Treat any apparent associated infection with Flucloxacillin or Clarithromycin
  • Refer if not resolved within 2 weeks of good compliance with treatment.
  • One of the conditions to be ruled out in this case is Paget’s Disease, however please note, this always affects the nipple and not just the areola.
  • If condition is clearly part of a more generalised skin rash without other breast symptoms, dermatology referral may be worth considering in the first instance.

 

 

 

Date Reviewed                                 03/12/2019

Next Review Date                           03/12/2020

Author                                                  Dr I Boyd, RMS GP Sifter

Contributor                                        Dr Rebecca Osborne, GPwSI Breast, RCHT

 

 

Version No.  1.0