What Is Breast Eczema?

Occurs in nipples, areola and its surroundings, with a clear realm, brownish red skin lesions, obvious erosion, intercalated with scales or thin palate, and cleft palate when infiltrated. Conscious itching combined with pain. More common in breastfeeding women, can be easily cured after stopping breastfeeding. If stubborn or one side occurs, care should be taken to rule out eczema-like cancer. Acute or repeated attacks can be delayed into subacute or chronic.

Basic Information

English name

breasteczema

Visiting department

dermatology

Multiple groups

Breastfeeding woman

Common locations

Nipple, areola

Common symptoms

Itching, pain

Causes of breast eczema

The cause of breast eczema is very complicated, and there are many interactions between internal factors and external factors. External factors such as living environment and climatic conditions can affect the occurrence of eczema. External stimuli such as cold, hot, dry, sweaty, scratching, rubbing, babies sucking nipples, milk and other stimuli are related. Some daily necessities such as cosmetics such as balms, soaps, artificial fibers, etc. can induce breast eczema. Certain foods can also make eczema worse in some people. Inherent factors such as chronic digestive system diseases, gastrointestinal dysfunction, mental stress, insomnia, excessive fatigue and other mental changes, infections, metabolic disorders and endocrine dysfunction can all cause or aggravate the condition of eczema.

From the perspective of pathogenesis, eczema is a late-type allergic reaction caused by complex internal and external stimulating factors. However, its etiology and the nature of the allergen, the characteristics of the immune response, and whether it is related to the delayed response mediated by IgE have not been fully elucidated. Patients may have certain qualities, the latter of which are governed by genetic factors, and therefore occur in certain people, but are also affected by conditions such as health and environmental conditions. For example, patients sometimes cannot tolerate many harmless stimuli in the living and working environment. For example, certain foods can make eczema worse. Patients are very sensitive, and they can react positively to many substances when patched in the laboratory; except for certain sensitizing factors, eczema lesions will not disappear quickly; but some patients will respond to the body by strengthening exercise and changing the environment. Sexual changes, and then accept the various stimuli that previously induced eczema, eczema can no longer occur. All this illustrates the complexity of its pathogenesis.

Clinical manifestations of breast eczema

Breast eczema is common in the nipples, areola, and surrounding areas. The realm is clear, the skin lesions are brown-red, the erosion is obvious, and the scales or thin palate are interspersed. Cleft palate can occur when there is infiltration. The patient was conscious of itching and pain. Eczema can be divided into acute, subacute, and chronic types based on skin lesions.

Acute eczema

The rash is most dense miliary small pimples, pimples, or small blisters, with basal flushing. Due to scratching, the skin lesions can show obvious point-like exudation and small erosive surfaces. The lesion center is often heavier, and gradually spreads around the periphery. There are scattered pimples and papules on the periphery, so the realm is unclear. When infection is associated, inflammation can be more pronounced, and pustules can form, pus exudate, or yellowish green or stained brown pimple. It can also be combined with folliculitis, palate, and local lymphadenitis.

2. Subacute eczema

When the inflammation of the acute eczema is alleviated, or the acute phase is not treated properly in time, the delay is long and subacute eczema occurs. The skin lesions are mainly small papules, scales, and scabs. There are only a few papules or small blisters and erosions, and there may be mild infiltration, and there is still severe itching consciously.

3. Chronic eczema

Mostly due to the repeated episodes of acute and subacute eczema, chronic inflammation can also begin to appear. The skin of the affected area is infiltrated and thickened, becoming dark red and pigmented, with a rough surface, covered with a few bran-like scales, or scabbing due to scratching, and there are individual moss-like changes with varying degrees, with limitations and clear edges There may also be papules and papules scattered around the periphery, and there may be obvious exudate during acute attacks. Symptoms are also markedly itchy and often paroxysmal. The course is uncertain, prone to relapse, and lasts forever.

No matter acute, subacute, chronic eczema, the course of disease is uncertain, easy to repeat, interchangeable and durable. Consciously itching is intense. Drinking, scratching, soapy water, hot water, etc. can make skin lesions worse, increase itching, and severe cases can affect sleep.

Breast Eczema Diagnosis

Diagnosis is not difficult according to the typical skin lesions of the nipple and areola skin.

Differential diagnosis of breast eczema

Must be distinguished from breast eczema-like cancer. The latter is older and more common around the age of 50. Sudden changes in breast eczema-like changes, and even ulceration and nipple ulceration or disappearance. In the later stage, there may be lumps in the breast and nipple discharge or other changes. Examination of exfoliated cells on the skin or examination of the skin, and examination of scraped skin tissue can help diagnosis. Excision biopsy has the most diagnostic value.

Breast Eczema Treatment

1. General prevention principles

(1) As far as possible to find the cause of the disease, it is necessary to make a deep understanding of the patient's working environment, living habits, diet, hobbies and thoughts and emotions, etc., and to conduct a comprehensive inspection of the city's situation, whether there are chronic lesions and internal organ diseases to remove Possible pathogenic factors.

(2) Avoid all kinds of external stimuli, such as hot water scalding, violent scratching, excessive swabbing, and other patient-sensitive substances such as fur products.

(3) Avoid foods that are sensitive and irritating, such as fish, shrimp, strong tea, coffee, alcohol, etc.

(4) Explain the protection points in detail to the patient and guide the medication. For patients with severe eczema combined with breastfeeding, breastfeeding can be used.

2. Drug treatment

(1) Internal therapy Western medicine can choose antihistamines to relieve itching. For acute or subacute generalized eczema, 5% calcium bromide, 10% calcium gluconate, or 10% sodium thiosulfate solution can be administered intravenously, once a day, 10 times as a course of treatment. Cooperate with effective antibiotic treatment for those with extensive infection. In addition, vitamin B family, vitamin C and drugs that regulate nerve function can also help.

Oral or injection of glucocorticoids is generally not suitable. Although this drug has a rapid effect on anti-inflammatory, antipruritic and reducing exudate, it relapses quickly after discontinuation, and long-term application is likely to cause many adverse reactions.

(2) Topical therapy The principle is the same as that for contact dermatitis. Choose appropriate dosage forms and drugs according to skin lesions. For small-scale subacute eczema, the application of glucocorticoid cream and external application with tar preparations are better. Local immunomodulatory drugs such as 0.03%, 0.1% tacrolimus ointment, or 1% pimecrolimus ointment have good curative effects and can reduce adverse reactions caused by long-term application of glucocorticoids.

(3) Traditional Chinese Medicine Acute eczema is mainly for clearing away heat and dampness. If you have a purulent infection, you can choose to add iridium, dandelion, honeysuckle, forsythia and so on. Subacute eczema is mainly for strengthening the spleen and dampness, supplemented by clearing heat, and adding and removing Weiling Decoction. Chronic eczema should be based on nourishing blood and removing wind, supplemented by clearing away heat and dampness.