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oozing sore on my areola
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oozing sore on my areola

Dear doctor

I have been bothered by this condition for about a month by now. I was 28 weeks pregnant when it first started by itchy breast skin. I then thought it was bra not fitting so I changed bra. The symptom didn't go away though. I probably scratched my breast at night when I can't control myself better. Than about a week later I found an open sore on my left aerola at around 9 o'clock position (from observer's point of view) that oozes a yellowish clear liquid and itches. It will ooze enough that my underwear will stick to the sore and taking my underwear off is a nightmare. After another week the same thing happened on my right side breast at 3 oclock position(exactly symmetric with the left side). The sore enlarged over the next 2 weeks and now the sore on my left side is size of a penny and on my right is half. The whole breasts are itchy with patches of small red bumps and very sensitive skin that will redden and thicken due to slight friction or scratch. While this is going on I have small red bumps with a tiny pin head filled with clear liquid appearing on my other part of the body, mainly on the back of my right hand, forming a small cluster pretty much like that on my areola, and few scattered ones on my arms, belly, and legs. when they pop they ooze too. Now I have to go topless so that the sores at my areola don't stick to clothes, but rather be crusted over. I am very worried about this condition, and I am afraid if it is a bad infectious virual infection that I can pass to my husband or my unborn child, and I wonder if I still can nurse. My ob doctor took a look at it and checked HSV I/II conbined and HSV II specific, the results are: HSV I/II IgM 1.03(equivocal), HSV I/II IgG 37 (positive), HSV II IgG <0.91 (negative), Vericella IgM <0.91 (negative) and IgG 2.07 (positive). Do you have any idea of what this might be? and can I still breast feed my baby?
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Welcome to the Dermatology Expert Forum! It is very good you reached out for help because we will share some very useful information in regards to your condition.  

First of all, this does not sound like a flare of HSV infection.

Disseminated (not really clustered), pruritic (itchy) erythematous (red) papules (“small bumps”), vesicles (“small blisters”) filled with clear fluid, and erosions are more likely to be clinical manifestations of one of the late pregnancy related dermatoses such as PUPPP (Polymorfic Eruption of Pregnancy) or AEP (Atopic Eruption of Pregnancy).  Of course, Pemphigoid gestationis should be ruled out. Spontaneous remission within few weeks after delivery is most common course of these pregnancy related conditions.

Contact dermatitis (with dissemination) is an option too. If that is the case, causative agent should be identified and removed, possible while taking your medical history; (it could have been something you were applying on your skin).

There is no reason not to breastfeed. However, healing of areolar and periareolar skin might be more difficult because newborns tend to cause soreness in that area.

Bottom line, you should see a dermatologist as soon as possible to get symptomatic therapy that will reduce pruritus (itch) and promote healing of damaged skin.

We wish you and your family very best.

Yours in Optimal Health,
Dr Jasmina Jankicevic
2 Comments
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oh, i forgot to mentione, that my ob also did a culture for general bacteria/yeast, nothing grow in it. also a herpes culture, negative too. She seem to be very determined it is herpes infection on my breast.
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