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Raynaud Phenomenon of the Nipple: An Under-Recognized Condition
Sierra Jansen1, Katherine Sampene
1Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Meriter Hospital, and the Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Background:
Obstetricians often feel ill-equipped to address the symptom of breast pain in pregnant and postpartum patients.
Cases:
In the first case, a 40-year-old woman in the second trimester of pregnancy reported nipple discoloration and severe pain. She was treated with nifedipine, and her symptoms decreased quickly and markedly. In the second case, a 32-year-old woman presented for a routine postpartum visit. She described breast pain and sporadic purple discoloration of the nipples, a finding confirmed on examination. Conservative measures of maintaining warmth were recommended.
Conclusion:
Raynaud phenomenon of the nipple is an underdiagnosed condition affecting women in both the prenatal and postpartum periods. A careful history and physical must be obtained in women presenting with breast pain, because diagnosis and treatment allows breastfeeding continuation and mitigation of symptoms.
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