The best part of practicing breastfeeding medicine is that I am always learning something new, particularly from my dermatology colleagues. This patient had developed these spots (just her right breast) while breastfeeding her first baby. They went away after weaning. They returned at 6 weeks postpartum while breastfeeding her second in the exact same location, and she came to me at 9 months wondering what this was. I didn’t know and biopsied it. I reached out to my two favorite dermatologists, Aegean Chan and Meredith Perrin, who speculated that it could be granuloma annulare. They were correct — the pathology results from the biopsy confirmed this.
Granuloma Annulare is a benign skin condition with unknown etiology, though there’s some speculation it’s immune related or as a result of skin injury (in her case, possibly from the baby’s body against her breast repetitively). It’s generally painless and asymptomatic (as hers was) and resolves on its own in a year or two (as hers had done after weaning her first baby).
If someone is particularly interested in resolving the discoloration, steroids or light therapy can be used to speed the process.
