![]() We suggest that this distinctive clinicopathologic entity be called pregnancy-associated hyperkeratosis of the nipple. The characteristic clinicopathologic features of this disorder allow differentiation from nevoid hyperkeratosis of the nipple and areola. It may represent a physiologic change of pregnancy. Pregnancy-associated hyperkeratosis of the nipple can be symptomatic and persist post partum. Differential diagnosis for a breast lump during pregnancy and postpartum period. Histopathologic features were conspicuous orthokeratotic hyperkeratosis, with papillomatosis and acanthosis being mild or absent. The lesions persisted post partum in 22 patients (88%). Nine patients (36%) experienced symptomatic aggravation only during pregnancy or breastfeeding. Lesions were symptomatic in 17 patients (68%), causing tenderness or discomfort, pruritus, sensitivity to touch, and/or discomfort with breastfeeding. The lesions were bilateral and involved predominantly the top of the nipple. Twenty-five cases of pregnancy-associated nipple hyperkeratosis identified during a 5-year period (January 1, 2007, through December 31, 2012) are reported. We performed a clinicopathologic analysis of cases of pregnancy-associated nipple hyperkeratosis. Hyperkeratosis of the nipple and/or areola can develop in the context of inflammatory diseases (such as atopic dermatitis), in acanthosis nigricans, as an extension of epidermal nevus, after estrogen treatment, and/or in nevoid hyperkeratosis of the nipple and areola. You may even find that sleeping in a bra at night provides comfort.Reported physiologic nipple changes in pregnancy do not include hyperkeratosis and are expected to resolve or improve post partum. This tenderness or pain can be reduced by wearing a well-fitting, supportive bra. The growth of your breasts during pregnancy can cause tenderness or even pain. Development includes puberty, pregnancy, and lactation. It requires the breast to change in composition, size, and shape during each stage of female development. Keep in mind that you may experience one of these, or some of these, more than the others. The normal physiology of lactation is a process that begins to take effect well before the initial latch of the newborn infant.
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