Differential Diagnosis for Purple Nipple
- Single most likely diagnosis
- Ecchymosis or bruising: This is the most likely diagnosis for a purple nipple, as it can result from trauma, injury, or even vigorous sucking during breastfeeding.
- Other Likely diagnoses
- Nipple eczema or dermatitis: Inflammatory conditions of the nipple can cause discoloration, including purple hues, due to the inflammation and potential bleeding into the skin.
- Paget's disease of the nipple: A rare form of breast cancer, but when considering nipple changes, it's a plausible differential. It often presents with eczematous changes, which can include discoloration.
- Montgomery's tubercles: These are small bumps on the nipple that can become more pronounced during pregnancy or breastfeeding. While not typically purple, any inflammation or infection could potentially cause a color change.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Breast cancer: Although Paget's disease is mentioned above, any unusual change in the nipple, including color, should prompt an evaluation for underlying breast cancer.
- Inflammatory breast cancer: This aggressive form of breast cancer can cause skin changes, including redness and purplish discoloration due to the inflammation and potential vascular involvement.
- Rare diagnoses
- Sarcoidosis: A systemic disease that can cause skin lesions and potentially affect the nipple, leading to discoloration.
- Tietze's syndrome: An inflammatory condition of the cartilages of the ribs, which could potentially cause referred pain and, in rare cases, skin changes if the inflammation affects the skin over the breast area.
- Vasculitis: Certain types of vasculitis can cause skin discoloration, including purplish hues, due to inflammation of blood vessels.