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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes brown spot and pus filled flat scab on nipple?

I am a 24 year old female, not pregnant or breast feeding. I all of a sudden have a brown spot directly on my nipple, looks almost like a flat scab, yellow puss comes out of it. There are 2 smaller brown spots on my nipple as well as tiny blisters that clear fluid comes out of. It is painful, swollen, and will not go soft. Could this be pagats disease ? What would cause this suddenly ? I would like as much information as possible before seeing my doctor please !
Fri, 17 Apr 2020
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General Surgeon 's  Response
Hello,

* The brown spot with pus filled flat scab on nipple most likely indicates soft tissue infection with gram positive bugs as staph aureus most likely.

Paget`s disease of breast do not present with this type of presentation (almost all have bleeding ) and your age is also against that.

However, a clinical examination with your primary care provider is must to get precise clinical diagnosis and further guidelines.

Till that time, my guidelines for better recovery
- keep the nipple clean with antiseptic liquid or soap
- apply neosporin cream 3 times a day
- wear loose, clean, cotton inner wears and avoid all tight bra
- avoid nipple stimulation or sucking by partner ( if applicable )

* In my clinic, I do prefer antibiotics as Penicillin with combination of Beta lactamase inhibitor ( mox clav or else ) or another ones as per the culture report of the pus swab.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr. Bhagyesh V. Patel
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What causes brown spot and pus filled flat scab on nipple?

Hello, * The brown spot with pus filled flat scab on nipple most likely indicates soft tissue infection with gram positive bugs as staph aureus most likely. Paget`s disease of breast do not present with this type of presentation (almost all have bleeding ) and your age is also against that. However, a clinical examination with your primary care provider is must to get precise clinical diagnosis and further guidelines. Till that time, my guidelines for better recovery - keep the nipple clean with antiseptic liquid or soap - apply neosporin cream 3 times a day - wear loose, clean, cotton inner wears and avoid all tight bra - avoid nipple stimulation or sucking by partner ( if applicable ) * In my clinic, I do prefer antibiotics as Penicillin with combination of Beta lactamase inhibitor ( mox clav or else ) or another ones as per the culture report of the pus swab. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr. Bhagyesh V. Patel