Supernumerary nipple

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Supernumerary nipple
Other namesThird nipple, triple nipple, accessory nipple, [1] polythelia
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Specialty Medical genetics, dermatology

A supernumerary nipple is an additional instance of nipple occurring in mammals, including humans and monkeys. They are often mistaken for moles. Studies variously report the prevalence of supernumerary nipples as approximately 1 in 18 and 1 in 40. [2] [3] [1]

Contents

The nipples appear along the two vertical "milk lines", which start in the armpit on each side, run down through the typical nipples and end at the groin. They are classified into eight levels of completeness, from a simple patch of hair to a milk-bearing breast in miniature. [4] [5]

Types

Type Glandular tissue Nipple Areola Fat tissue Hair patch
1yesyesyesyes
2yesyes
3yesyes
4yes
5 ("pseudomamma")yesyesyes
6 ("polythelia")yes
7 ("polythelia areolaris")yes
8 ("polythelia pilosa")yes [6]

Polythelia refers to the presence of an additional nipple alone, while polymastia denotes the much rarer presence of additional mammary glands.

Although usually presenting on the milk line, pseudomamma can appear as far away as the foot. [7]

A possible relationship with mitral valve prolapse has been proposed. [8]

Clinical significance

Clinical presentation

It may remain undetected. Occasionally, the supernumerary nipple is noticed when hormonal changes during adolescence, menstruation, or pregnancy cause increased pigmentation, fluctuating swelling, tenderness, or even lactation.

Associations

It is said to be found in association with many syndromes and other conditions:

Treatment and prognosis

Most often no treatment is required; however, a protruding embarrassing supernumerary nipple can be removed surgically, if desired. Removal using liquid nitrogen cryotherapy has also been described.

Society and culture

Television

The Triple Nipple Club is a documentary shown on Channel 4 which explored the biological mystery of the supernumerary nipple. [9] First broadcast on 2 January 2008, it was directed and produced by Dan Louw and commissioned as part of Channel 4's First Cut series. [10] The film focuses on Louw's attempts to understand why he was born with extra nipples, a condition he shares with the likes of Mark Wahlberg, [11] Lily Allen, [12] and Tilda Swinton, as well as TV and film characters such as the James Bond villain Francisco Scaramanga and Chandler Bing from Friends. Fascinated and confused by this seemingly pointless mutation, Louw sets off on a personal journey of discovery to try and unwrap "the riddle of the triple nipple". He starts out by consulting the man in the street and a renowned teratologist, an expert in physical mutations. After testing the notion that extra nipples could be a sign of fertility, he discovers that they are actually an atavism, or evolutionary 'holdover'—a sign of how humans evolved. [13]

English pop-star Harry Styles confirmed in 2017 that he has four nipples as a result of the condition. [14]

See also

Related Research Articles

<span class="mw-page-title-main">Breast</span> Region of the torso of a primate that in females serves as a mammary gland

The breast is one of two prominences located on the upper ventral region of the torso among humans and other primates. Both sexes develop breasts from the same embryological tissues. The relative size and development of the breasts is a major secondary sex distinction between males and females.

<span class="mw-page-title-main">Marfan syndrome</span> Genetic disorder involving connective tissue

Marfan syndrome (MFS) is a multi-systemic genetic disorder that affects the connective tissue. Those with the condition tend to be tall and thin, with long arms, legs, fingers, and toes. They also typically have exceptionally flexible joints and abnormally curved spines. The most serious complications involve the heart and aorta, with an increased risk of mitral valve prolapse and aortic aneurysm. The lungs, eyes, bones, and the covering of the spinal cord are also commonly affected. The severity of the symptoms is variable.

<span class="mw-page-title-main">Nipple</span> Part of the breast

The nipple is a raised region of tissue on the surface of the breast from which, in females, milk leaves the breast through the lactiferous ducts to breastfeed an infant. The milk can flow through the nipple passively or it can be ejected by smooth muscle contractions that occur along with the ductal system. Male mammals also have nipples but without the same level of function, and often surrounded by body hair.

<span class="mw-page-title-main">Mammary gland</span> Exocrine gland in humans and other mammals

A mammary gland is an exocrine gland in humans and other mammals that produces milk to feed young offspring. Mammals get their name from the Latin word mamma, "breast". The mammary glands are arranged in organs such as the breasts in primates, the udder in ruminants, and the dugs of other animals. Lactorrhea, the occasional production of milk by the glands, can occur in any mammal, but in most mammals, lactation, the production of enough milk for nursing, occurs only in phenotypic females who have gestated in recent months or years. It is directed by hormonal guidance from sex steroids. In a few mammalian species, male lactation can occur. With humans, male lactation can occur only under specific circumstances.

<span class="mw-page-title-main">Mitral valve prolapse</span> Medical condition

Mitral valve prolapse (MVP) is a valvular heart disease characterized by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole. It is the primary form of myxomatous degeneration of the valve. There are various types of MVP, broadly classified as classic and nonclassic. In severe cases of classic MVP, complications include mitral regurgitation, infective endocarditis, congestive heart failure, and, in rare circumstances, cardiac arrest.

<span class="mw-page-title-main">Inverted nipple</span> Medical condition

An inverted nipple is a condition where the nipple, instead of pointing outward, is retracted into the breast. In some cases, the nipple will be temporarily protruded if stimulated. Both women and men can have inverted nipples.

<span class="mw-page-title-main">Accessory breast</span> Condition of having an additional breast

Accessory breasts, also known as polymastia, supernumerary breasts, or mammae erraticae, is the condition of having an additional breast. Extra breasts may appear with or without nipples or areolae. It is a condition and a form of atavism which is most prevalent in male humans, and often goes untreated as it is mostly harmless. In recent years, many affected women have had a plastic surgery operation to remove the additional breasts, for purely aesthetic reasons.

Mastopexy is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. In a breast-lift surgery to re-establish an aesthetically proportionate bust for the woman, the critical corrective consideration is the tissue viability of the nipple-areola complex (NAC), to ensure the functional sensitivity of the breasts for lactation and breast-feeding.

<span class="mw-page-title-main">Larsen syndrome</span> Congenital disorder

Larsen syndrome (LS) is a congenital disorder discovered in 1950 by Larsen and associates when they observed dislocation of the large joints and face anomalies in six of their patients. Patients with Larsen syndrome normally present with a variety of symptoms, including congenital anterior dislocation of the knees, dislocation of the hips and elbows, flattened facial appearance, prominent foreheads, and depressed nasal bridges. Larsen syndrome can also cause a variety of cardiovascular and orthopedic abnormalities. This rare disorder is caused by a genetic defect in the gene encoding filamin B, a cytoplasmic protein that is important in regulating the structure and activity of the cytoskeleton. The gene that influences the emergence of Larsen syndrome is found in chromosome region, 3p21.1-14.1, a region containing human type VII collagen gene. Larsen syndrome has recently been described as a mesenchyme disorder that affects the connective tissue of an individual. Autosomal dominant and recessive forms of the disorder have been reported, although most cases are autosomal dominant. Reports have found that in Western societies, Larsen syndrome can be found in one in every 100,000 births, but this is most likely an underestimate because the disorder is frequently unrecognized or misdiagnosed.

<span class="mw-page-title-main">Supernumerary body part</span> Growth of an additional part of the body and a deviation from the body plan

Supernumerary body parts are most commonly a congenital disorder involving the growth of an additional part of the body and a deviation from the body plan. Body parts may be easily visible or hidden away, such as internal organs.

Amastia refers to a rare clinical anomaly in which both internal breast tissue and the visible nipple are absent on one or both sides. It affects both men and women. Amastia can be either isolated or comorbid with other syndromes, such as ectodermal dysplasia, Syndactyly and lipoatrophic diabetes. This abnormality can be classified into various types, and each could result from different pathologies. Amastia differs from amazia and athelia. Amazia is the absence of one or both mammary glands but the nipples remain present, and athelia is the absence of one or both nipples, but the mammary gland remains.

<span class="mw-page-title-main">Ptosis (breasts)</span> Sagging of the female breast

Ptosis or sagging of the female breast is a natural consequence of aging. The rate at which a woman's breasts drop and the degree of ptosis depends on many factors. The key factors influencing breast ptosis over a woman's lifetime are cigarette smoking, her number of pregnancies, higher body mass index, larger bra cup size, and significant weight change. Post-menopausal women or people with collagen deficiencies may experience increased ptosis due to a loss of skin elasticity. Many women and medical professionals mistakenly believe that breastfeeding increases sagging. It is also commonly believed that the breast itself offers insufficient support and that wearing a bra prevents sagging, which has not been found to be true.

<span class="mw-page-title-main">MASS syndrome</span> Medical condition

MASS syndrome is a medical disorder of the connective tissue similar to Marfan syndrome. MASS stands for mitral valve prolapse, aortic root diameter at upper limits of normal for body size, stretch marks of the skin, and skeletal conditions similar to Marfan syndrome. It is caused by a mutation in the FBN1 gene, which encodes fibrillin-1. Fibrillin-1 is an extracellular matrix protein that is found in microfibrils; defects in the fibrillin-1 protein cause the malfunctioning of microfibrils, which results in improper stretching of ligaments, blood vessels, and skin.

Breast diseases make up a number of conditions. The most common symptoms are a breast mass, breast pain, and nipple discharge.

<span class="mw-page-title-main">Duct ectasia of breast</span> Medical condition

Duct ectasia of the breast, mammary duct ectasia or plasma cell mastitis is a condition that occurs when a milk duct beneath the nipple widens, the duct walls thicken, and the duct fills with fluid. This is the most common cause of greenish discharge. Mammary duct ectasia can mimic breast cancer. It is a disorder of peri- or post-menopausal age.

Pigmented hairy epidermal nevus syndrome, also known as Becker's naevus syndrome, is a cutaneous condition characterized by a Becker nevus, ipsilateral hypoplasia of the breast, and skeletal defects such as scoliosis.

<span class="mw-page-title-main">Ulnar–mammary syndrome</span> Human disease

Ulnar–mammary syndrome or Schinzel syndrome is a cutaneous condition characterized by nipple and breast hypoplasia, i.e. underdevelopment. Features of UMS can be mild to severe and can vary significantly from person to person, even within the same family. The main features of UMS include upper limb defects, underdevelopment of the apocrine and mammary glands, and various genital abnormalities. Other signs and symptoms may include hormonal deficiencies, delayed puberty, dental problems and obesity. People with UMS may have distinct facial features, including a wide face tapering to a prominent chin, and a broad nose.

<span class="mw-page-title-main">Scalp–ear–nipple syndrome</span> Medical condition

Scalp–ear–nipple (SEN) syndrome is a condition associated with aplasia cutis congenita.

<span class="mw-page-title-main">Supernumerary nipples–uropathies–Becker's nevus syndrome</span> Medical condition

Supernumerary nipples–uropathies–Becker's nevus syndrome is a skin condition that may be associated with genitourinary tract abnormalities. Supernumerary nipples, also referred to as polythelia or accessory nipples, is a pigmented lesion of the skin that is present at birth. This pigmentation usually occurs along the milk lines, which are the precursors to breast and nipple development. Clinically, this congenital condition is generally considered benign, but some studies have suggested there may be an association with kidney diseases and cancers of the urogenital system.

Papillomatosis of the breast (PB) is a rare, benign, epitheliosis-like lesion, i.e. an overgrowth of the cells lining the ducts of glands that resembles a papilla or nipple-like nodule/tumor. PB tumors develop in the apocrine glands of the breast. PB is also termed juvenile papillomatosis because of its frequent occurrence in younger women and Swiss cheese disease because of its microscopic appearance. Rarely, PB has also been diagnosed in very young, adolescent, and adult males.

References

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  2. Supernumerary nipples: prevalence, size, sex and side predilection – a prospective clinical study, H. Schmidt, European Journal of Pediatrics volume 157, pages 821–823 (1998).
  3. Occurrence of Supernumerary Nipples in Newborns Francis Mimouni, MD; Paul Merlob, MD; Salomon H. Reisner, MB, ChB, Am J Dis Child. 1983;137(10):952-953.
  4. Kajava Y. "The proportions of supernumerary nipples in the Finnish population". Duodecim 1915; 1:143-70.
  5. Revis, Don R. Jr. "Breast Embryology" . eMedicine. Archived from the original on 22 December 2008. Retrieved 3 December 2007.
  6. Camacho F.; González-Cámpora R. (1998). "Polythelia pilosa: A Particular Form of Accessory Mammary Tissue". Dermatology. 196 (3): 295–298. doi:10.1159/000017924. PMID   9621135. S2CID   25211741.
  7. Conde, Délio Marques; Kashimoto, Eiji; Torresan, Renato Zocchio; Alvarenga, Marcelo (2006). "Pseudomamma on the foot: An unusual presentation of supernumerary breast tissue". Dermatology Online Journal. 12 (4): 7. doi:10.5070/D339n411b8. PMID   17083862 . Retrieved 3 December 2007.
  8. Rajaratnam K, Kumar PD, Sahasranam KV (2000). "Supernumerary nipple as a cutaneous marker of mitral valve prolapse in Asian Indians". Am. J. Cardiol. 86 (6): 695–697. doi:10.1016/S0002-9149(00)01057-2. PMID   10980229.
  9. Throwback | First Cut: The Triple Nipple Club | Free Video Clips from Channel 4
  10. Channel 4 - FourDocs blog - First Cut line-up
  11. AskMen.com - Mark Wahlberg's third nipple love
  12. YouTube - Lilly Allen Third Nipple
  13. McCarthy, Susan (8 June 1999). "Why do men have nipples?". Salon. Archived from the original on 5 December 2022.
  14. Donahue, Rosemary (19 July 2017). "Harry Styles Has Four Nipples, and That's More Common Than You Think". Allure. Archived from the original on 17 January 2023. Retrieved 17 January 2023.