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What causes scaling on the nipple?

DOCTOR OF THE MONTH - May 2014
May 2014
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Radiologist
Practicing since : 2002
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Question
25 Male with Gynomestia. On Left nipple (Same side Chest/breast that has the gyno (left)) noticed Brown Scaling/crust on nipple. Dosnt itch. No pain. What would this be?
Posted Sun, 23 Mar 2014 in General Health
 
 
Answered by Dr. Vivek Chail 1 hour later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX, Thanks for writing in to us. The commonest cause for crusting or scaling on the nipple of your breast is expansion of the skin due to gynecomastia which might be causing these changes. This is usually not accompanied with any pain or itching. The other causes which can cause crusting of nipple include skin changes due to eczema but this is often present with itching and may affect other part of the body. If there is appearance of pain and discharge then an infection must be ruled out. Malignancy presenting with only crusting of nipple is rare. I suggest you visit a surgeon and confirm your condition. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek
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Follow-up: What causes scaling on the nipple? 51 minutes later
Thank you for your response.. as a follow up I have had Gynomestia for 3 years and this is first time I have noticed it..I may also note that I did take a substance that did aggravate my condition about 3 months ago and occasionally I do notice clear discharge from my nipple.. So just confirming the scaling is most likely to do with my Gynomestia? Again thank you for your help.
 
 
Answered by Dr. Vivek Chail 6 hours later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in with an update. The clear discharge from the nipple needs further evaluation. Clear discharge is known to occur in gynecomastia. Its important to know if application of the substance had an allergic effect and caused damage to the skin around the nipple and any infective condition. The scaling can be due to gynecomastia itself or an infection. Initial; stages of infection do not cause pain or itching. Please observe it closely and have it examined by your doctor if possible. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek
Above answer was peer-reviewed by
 
Follow-up: What causes scaling on the nipple? 8 hours later
Yes When i stopped using substance (3 months ago) the Gynomestia was not sore..this was months ago so that is why I was curious as to why yesterday my nipple looked scaly.. ? The discharge started 3 years ago once I developed Gynomestia and occasionally since then happens So by observing it should I be worried if it is in pain ( I will get it checked out when I can) , is that the tell-tale sign of something serious besides side effects from gynomestia?
 
 
Answered by Dr. Vivek Chail 10 hours later
Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in with an update. If the nipple discharge was non foul smelling and does not have blood component then it is due to gynecomastia and not an infection/ inflammation. However, you need to consult an endocrinologist and get investigated completely and I guess you are doing the same. Serious indicators in your case would be any lump in and around the breast or nipple, any foul or blood stained discharge, appearance of ulcerations over skin, lymph node swelling in your armpits or over the collar bone. The scaly skin changes can be commonly due to the skin over the nipple getting stretched. You may apply a moisturizer and observe for a week. If it persists further then consulting a doctor is necessary. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek
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