papillitis and areola

Introduction

Introduction to papillitis and areola Papillitis and areolitis are suppurative inflammation of the nipple and areola skin and glands caused by infection of golden grape balls, etc., which occur mostly in women's lactation period, improper treatment, can develop into mastitis, Chinese medicine Call this disease "nipple wind". basic knowledge The proportion of illness: 0.025% of the specific population Susceptible population: occurs mostly in women's lactation Mode of infection: non-infectious Complications: acute cellulitis

Cause

The cause of papillitis and areola

Cleavage of the nipple epidermis (24%):

Lactation caused by excessive milk, overflowing the skin, long-term erosion caused by nipple erosion or eczema, causing damage to the nipple skin.

Nipple retraction or too small (25%):

When breastfeeding, the baby is sucked hard, and the skin is broken by biting the nipple.

Areola skin damage (15%):

There are sweat glands, accessory breasts and special sebaceous glands in the areola. The sebaceous glands in the areola are also called the areola glands, or the Montgomery glands. There are 10 to 15 on each side. The ring body is arranged near the nipple, and the position is shallow, forming at the areola. Small nodular protrusion, open on the areola alone, when the skin is damaged at the areola, the bacteria enter the gland, which is the areola inflammation. During pregnancy, the areola gland is significantly enlarged, the catheter is dilated, and the secretion of sebum is obviously increased. The areola tube is prone to blockage, and because the skin is thinner, it is easy to damage and cause secondary infection.

Infant oral infection (10%):

Oral bacteria contaminate the nipple and areola skin during breastfeeding, which is one of the causes of this disease.

Pathogenesis

Bacteria invade the nipple and areola-damaged skin, rapidly multiply in the tissues around the milk duct and the areola gland, producing toxins, causing local tissue degeneration and necrosis, and forming a center of abscess, which is characterized by local congestion, exudation, induration, and aggregation. The granulocytes destroy damaged tissue cells and pathogens, causing them to gradually necrosis and dissolve, forming an abscess under the dermis. Because the toxin of Staphylococcus aureus contains coagulase, it forms a pus, which protrudes outward and is clinically visible. There are a number of yellow-white pus in the center of the redness and induration. The inflammation is mostly local, and there is generally no systemic reaction.

Prevention

Prevention of papillitis and areola

Active nipple and areola care during pregnancy and lactation can effectively prevent the occurrence of papillitis and areola.

1. Do a good job of nipple hygiene during pregnancy: After 6 months of pregnancy, you should scrub the nipple with warm water every night to enhance the resistance of the local skin, keep the nipple and areola clean, and reduce the chance of bacterial infection.

2. Correction of nipple deformity: those with nipple retraction can often pull or massage the nipple to make it stand out, improving the difficulty of breastfeeding.

3. Empty the remaining milk: After breastfeeding, the remaining milk in the breast should be exhausted in time to prevent the spill and nipple skin from causing erosion.

4. Active treatment of eczema: When nipple eczema occurs, it should be treated promptly. For example, use San Miao San (18g of raw cold water stone, Bei Cangzhu, 9g of Chuanhuangbai, 3g of green barley powder, a total of fine powder) can be sprinkled on the wound or Mix thoroughly with the licorice oil, detoxification and dehumidification.

Use cork, white scorpion, half of the powder, and then mix with sesame oil or honey and apply to the affected area; or compound benzoin or basic strontium carbonate (4 g of basic strontium carbonate, powder, add 5 ml of vegetable oil); Also use talcum powder, 6g of red stone fat, 1.2g of borneol, research fine powder, mix well, dry and spread on the sore surface.

5. Actively deal with infant oral inflammation: When the baby's mouth is infected, in addition to timely treatment, if necessary, stop breastfeeding, and use a breast pump to suck out and then feed to reduce the chance of local infection of the nipple.

Complication

Papillitis and areola complication Complications acute cellulitis

The areola abscess can not discharge the pus in time, then continue to develop, can lead to breast abscess, at this time in addition to local red, swollen, hot, painful acute signs of infection, may be accompanied by symptoms of systemic poisoning, such as chills, high fever, general malaise, etc. .

Symptom

Papillitis and symptoms of areola inflammation Common symptoms Lactation disorders Cellulitis, areola, black baby, licking nipples... Scarring abscess

When the cleft palate, there are small cracks and ulcers on the surface of the nipple. After the epithelium is soaked, it can also be erosive. In the early stage of the disease, when the child is breast-feeding, there is a knife-like pain in the nipple, followed by bleeding or yellow water and surface scarring; Sucking, sputum detachment, the rupture gradually expands, and when the disease develops, an acute or subacute cellulitis or a partial abscess of the areola is formed under the areola, and the oily bean dregs are spilled after the ulceration.

Examine

Examination of papillitis and areola

Blood routine examination, the total number of peripheral white blood cells can be increased, and the proportion of neutrophils is increased.

Diagnosis

Diagnosis of papillitis and areola

According to the clinical manifestations of the nipple and areola, the diagnosis can be generally confirmed.

The nipple or areola caused by nipple eczema should be differentiated from Paget's disease. Before it develops into a cellulitis under the areola, there are similarities between the two, but the perimeter of the areola eczema is not clear, the skin is not thick, there is Significant itch, and the boundary between Paget's peripheral skin and normal breast skin is very clear, and the lesion skin is obviously thickened, dark purple, harder, no obvious itching and pain in the lesion area, this is a local lesion of Paget disease The characteristics of this disease are rarely complicated by cellulitis and abscess under the areola. Most of the patients are non-lactating women. In the late stage, there are many nipple retractions. The final diagnosis still needs pathological examination.

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