title: Raynaud's phenomenon of the nipple.
abstract: BACKGROUND
  Raynaud's phenomenon is a well-described pathologic state in which there is episodic vasospasm followed by vasodilation. It is described most commonly in the digits but also has been shown to affect the nipple vasculature. Raynaud's phenomenon of the nipple may result in discontinuation of breastfeeding secondary to pain and disruption of the maternal-infant bonding process.
  
  
  METHODS
  We present the cases of two patients with painful breastfeeding associated with color changes of the nipple. Owing to a clinical presentation similar to fungal infections, the patients were treated repeatedly with antifungals before the correct diagnosis was made. Symptoms resolved with a course of nifedipine.
  
  
  CONCLUSIONS
  Increased awareness in the obstetric field will lead to appropriate diagnoses, earlier treatment and relief, and more successful breastfeeding experiences.
authors.affiliation: From the Department of Obstetrics and Gynecology, National Naval Medical Center, and the Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Mae
authors.initials: M
authors.lastname: Wu
authors.forename: Rebecca
authors.initials: R
authors.lastname: Chason
authors.forename: Michelle
authors.initials: M
authors.lastname: Wong
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D006801:Humans; D009543:Nifedipine / Q000627:therapeutic use; D009558:Nipples / Q000503:physiopathology*; D010146:Pain / Q000209:etiology; D011928:Raynaud Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014665:Vasodilator Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014665:Vasodilator Agents; D009543:Nifedipine