Periductal Mastitis

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    Periductal mastitis (PDM) (also called Zuska’s Disease or subareolar abscess) can occur in the setting of breastfeeding, but is not a result or complication of breastfeeding. Treatment includes smoking cessation and kenalog injection into the lesion to treat chronic inflammation.

    Screenshot 2024 07 24 at 2.14.25 PM
    Periductal mastitis with nipple abscess and fistula at areolar border.
    Periductal mastitis always presents itself at the border of the areola. It tends to recur in a specific location on the areolar border with redness, pain, fluid collections, and fistulae.
    Periductal mastitis always presents itself at the border of the areola. It tends to recur in a specific location on the areolar border with redness, pain, fluid collections, and fistulae.
    Periductal mastitis always presents itself at the border of the areola. It tends to recur in a specific location on the areolar border with redness, pain, fluid collections, and fistulae.
    Periductal mastitis
    Periductal mastitis
    Periductal mastitis
    Periductal mastitis with abscess in nipple (black spot is old blood from drainage procedure in the ER).

    It’s not very common, but men can get periductal mastitis as well.  Here’s an example below that needed drainage and antibiotics to resolve.

    male periductal mastitis
    Male periductal mastitis resolved
    periductal mastitis
    After initial drainage and resolution, the patient recurred with more swelling and spontaneous drainage. We injected steroid at this point.

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    August 18, 2026