title: Nipple and areolar hyperpigmentation secondary to the use of estradiol spray on the ipsilateral forearm skin: a report of two cases.
abstract: BACKGROUND
  Metered transdermal estradiol spray may cause ipsilateral hyperpigmentation of the nipple and areola.
  
  
  METHODS
  Two women who were using transdermal estradiol spray for the treatment of postmenopausal symptoms developed hyperpigmentation of the ipsilateral areola and nipple. The appearance was variable in onset and did not appear to be related to the duration of use.
  
  
  CONCLUSIONS
  Estradiol transdermal spray can have the rare side effect of ipsilateral nipple and areolar hyperpigmentation. The time of onset can vary.
authors.affiliation: University of Texas Medical School-Houston, Houston, Texas 77030-1503, USA.
authors.forename: Asra
authors.initials: A
authors.lastname: Ali
authors.forename: Pamela
authors.initials: P
authors.lastname: Berens
authors.forename: Gazala
authors.initials: G
authors.lastname: Siddiqui
authors.forename: Vaseem
authors.initials: V
authors.lastname: Ali
mesh_terms: D000328:Adult; D004954:Esthetics; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000503:physiopathology*; D009558:Nipples; D012869:Skin Absorption; D013473:Sunscreening Agents / Q000009:adverse effects*
chemical_list: D013473:Sunscreening Agents