What are the most common causes of breast rash?

Common skin rashes

Common skin rashes can include:

The rashes listed above are not associated specifically with the breasts—they can appear virtually anywhere on the body, including the breasts.

Viral conditions such as measles, chickenpox or shingles could also produce rashes in the breast area. As with the conditions listed above, they are not due to a specific disorder of the breasts. They can, however, have serious health consequences and should be examined and treated as soon as possible.

Dermatitis or eczema of the nipple may occur in some breastfeeding women, as the nipples become irritated by the baby’s mouth, tight clothing or trapped moisture. Eczema of the nipple and areola can also be seen in women who are not breastfeeding .

Inflammatory breast cancer

Inflammatory breast cancer (IBC) is an aggressive breast cancer that develops when cancer cells get into lymph vessels draining the skin of the breast. When the vessels become blocked by cancer cells, symptoms begin to appear. These include:

  • Thickened skin
  • Rash or irritation that resembles an infection
  • Red, swollen and warm breast
  • Pitted skin on the breast, similar to that of an orange peel

Mastitis

Mastitis is a painful swelling of the breast that occurs most often in breastfeeding women, usually within three months of giving birth. An infection occurs when milk builds up inside the breast due to a clogged duct or some other factor that slows or prevents the flow of milk. This can also happen when breaks in the skin of the nipple allow bacteria to enter. Symptoms develop quickly and include:

It is also possible for non-breastfeeding women to experience mastitis, usually as a result of a cracked or sore nipple, or a nipple piercing allowing bacteria to get into the milk duct.

Breast abscess

A breast abscess is a buildup of pus underneath the skin of the breast caused by bacterial infection. A breast abscess is often linked to untreated mastitis, and usually affects women who are breastfeeding. The most common cause of mastitis or breast abscess in non-breast-feeding women is duct ectasia, a condition where the ducts behind the nipple are enlarged and can harbor secretions containing bacteria.

Symptoms include:

  • Red and inflamed skin
  • Skin that is warm to the touch
  • Fever
  • Localized swelling

Mammary duct ectasia

Mammary duct ectasia is a non-cancerous condition that occurs when a milk duct in the breast widens and its walls thicken. As a result, the duct becomes blocked and leads to a buildup of fluid. Many times this condition will cause no symptoms and is only found when conducting a biopsy for another breast condition. If symptoms do occur, they can include:

  • Discharge of thick white toothpaste-like material from the nipple
  • Redness and tenderness in the nipple and nearby breast tissue
  • Inverted nipple
  • Scar tissue around the affected milk duct causes a noticeable lump that may be confused with cancer

An ultrasound or mammogram can be performed to get a clear picture of the breast’s condition. If a lump is present, a biopsy may be done to ensure that no cancer is present.

Paget’s disease of the breast

Paget’s disease of the breast is a rare form of breast cancer (1 to 4 percent of all cases of breast cancer) that involves the skin of the nipple and can extend onto the areola (the dark-colored skin around the nipple). Most people with this disease also have one or more tumors in the same breast, the most common tumors being either ductal carcinoma in situ or invasive breast cancer.

In Paget’s disease of the breast, cancerous cells are found in the top layer of the skin of the nipple and areola. Such cells are identified when looked at under a microscope following tissue biopsy. It is not yet certain whether cancer cells from tumors inside the breast travel through the milk duct and deposit on the nipple, or whether cancer can develop separately in just the nipple.

Symptoms of the disease include:

  • Itching, tingling, or redness in the nipple area
  • Flaky, crusty, or thickened skin (resembling eczema)
  • A flattened nipple
  • Yellow or bloody leakage from the skin of the nipple

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