X-post -insight and referral needed - dermatological issue or breastfeeding issue?

[Guest guest]

Greetings,

I am posting this for a friend who lives in another state, so I have not

been able to see her personally. 2nd baby is 5 months old. approximately

2 months ago, she noticed a painful white spot on her nipple and called

me. She has a history of plugged ducts, and has taken lecithin for much of

her nursing " career " . We figured it was a bleb, and she treated it as

such, but it never went away, and in fact got worse. She called me again,

and after many questions, I began to suspect it was yeast, and she felt

that was the case too. The symptoms fit, and she began APNO and gentian

violet (2 rounds of 4-5 days each). It seemed to improve a little bit, but

then returned, and stayed. We talked again, and she succeeded in getting a

2 week scrip for diflucan 400 mg loading, 100 or 200 (not sure which) BID

for 2 weeks. No improvement. SHe continued the APNO through all this.

I began to feel concerned that it was something unrelated to breastfeeding,

and since I haven't seen it, I really want someone who knows what they are

looking at to see it! I worry about Paget's of course, but i wonder if it

could be something dermatological, as well. It is unilateral. On my

urging, she called her dermatologist (she does have rosacea and another

condition i cannot remember that causes rough skin patches) to make an

appointment for those conditions and ask about the nipple issue. her derm.

said he wouldn't treat lactating mothers for the nipple issue, because it

was a breastfeeding/milk duct issue, not dermatological. He made an

appointment for her several weeks out for the other conditions. I am

floored by this.

Anyhow, I suggested she call the lactation center at her local hospital to

get a referral for a dermatologist. If anyone has any imput or ideas I

would really welcome them, what could this be??

Also, if anyone lives in the Kansas City, KS area and knows of a

knowledgable dermatologist or someone else she might see, i would welcome

that referral as well.

Thanks so much,

Lyla Wolfenstein, B.S., IBCLC, RLC

www.beyondbirthservices.com

Lyla@...

Portland, Oregon

Lyla Wolfenstein