Friday, June 29, 2007

Lactating Mother

The patient is a 23 yo woman who is nursing a 4 month old infant. She has had psoriasis since childhood, often quite severe. A single mother, she comes from a disadvantaged family and is trying to do all the right things for her young daughter. Her breasts are painful from the plaques and nursing.

[I apologize for the blurry picture. The battery was low and would not allow me to use macro function -- but you can get the idea.]



I think this is psoriasis of areolae caused by the trauma of nursing. The question is how to treat. The young mother wants to continue breast feeding for a few more months.
How would you treat the aroelae and nipples considering that a baby will be sucking on the area?
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5 comments:

  1. Dr Ian McCollJune 29, 2007

    I would try a dilute topical steroid such as 1% hydrocortisone first with the cream being washed off before a feed and applied again immediately afterwards. If there is any suggestion of associated candida then add in some clotrimazole cream. The combination usually works well and is not toxic to the baby.

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  2. AnonymousJune 29, 2007

    Agree with the diagnosis and suggested therapy. I've seen many cases of psoriasis aggravation during puerperium period. I beleive hormones definetly play some role in psoriasis. Cheers,
    Omid

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  3. AnonymousJuly 25, 2007

    you can try "APNO" (all-purpose nipple ointment); see http://www.breastfeed-essentials.com/allaboutcreams.html
    for more details

    ReplyDelete
  4. AnonymousMarch 31, 2009

    I Think fondle these boobs a lot because she is a single mother and none should help her except the baby's Father.

    ReplyDelete
  5. AnonymousJanuary 06, 2010

    i'd say a big load of seminal fluid would do the trick.

    ReplyDelete

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