Bilateral nipple necrosis in a breastfeeding woman with Behçet's disease

Abstract

Behçet's disease is a chronic, multisystem disorder. A 23-year-old female patient diagnosed with Behçet's disease 3 years earlier was admitted with deep ulcers on both areolas caused by detachment of the nipples following breastfeeding since spontaneous delivery of her baby. Physical examination revealed a necrotic ulcer crater 2 cm in diameter on each breast, with the lactiferous ducts draining into these. Incisional biopsy sample from the areola ulcer border on the left breast showed leukocytoclastic vasculitis. Breastfeeding was stopped, and local wound care and systemic corticosteroid therapy were started. After 4 weeks, epithelization tissue filled the ulcers, leveling the crater base with the areola. Bilateral nipple necrosis in a breastfeeding woman is a rare entity. It is thought that in the present case minor trauma caused by breastfeeding accompanied by neutrophilic infiltration resulting from amplified inflammatory response and leukocytoclastic vasculitis attributable to Behçet's disease was responsible for the necrosis. © 2002 Elsevier Science Ltd. All rights reserved.