Pregnancy-associated hyperkeratosis of nipple/areola

Hyperkeratosis of nipple is uncommon, benign, asymptomatic, acquired condition of unknown pathogenesis. Most cases are bilateral, although unilateral cases had been reported. Breastfeeding is usually not affected. Physiologic changes of the nipple and areola during pregnancy include enlargement, hyperpigmentation, secondary areolae, erectile nipples, prominence of veins, striae, and enlargement of the Montgomery glands or tubercles (hypertrophied sebaceous glands). Women with unilateral primary hyperkeratosis of the nipple and/or areola may have bilateral disease during pregnancy (secondary hyperkeratosis of the nipple and/or areola). Pregnancy may also produce thicker, darker lesions. Here, we report a case of pregnancy-associated hyperkeratosis of nipple in a primigravida. We counseled her about benign nature of the condition and treated her with topical steroids and moisturizers.