title: "Seeing Is Believing": Dermatoscope Facilitated Breast Examination of the Breastfeeding Woman with Nipple Pain.
abstract: It is well recognized that breastmilk provides optimal nutrition and immunological protection for infants. Many women, however, experience nipple pain while breastfeeding, leading to premature cessation of nursing. To overcome these difficulties, timely diagnosis is crucial to effectively treat the underlying pathology and permit resumption of breastfeeding. Examination of the superficial breast plays a key role in accurate diagnosis. Traditional direct inspection is clearly inadequate for this task.
  
  
  
  The dermatoscope is a useful tool, enlarging and illuminating an area of epidermis to obtain an optimal image. Improvements in dermoscopy involving polarization obviate the need for full contact with the examined surface, thereby providing anatomical detail in three dimensions.
  
  
  
  A novel practice presented in this article features clinical cases introducing this technique as it is applied to the lactating breast, conclusively distinguishing normal from abnormal and illustrating the efficacy and added diagnostic value of this approach. The dermoscope is shown to facilitate identification of the causes of nipple pain ranging from asymptomatic candidal infection to exquisitely painful, minute traumatic erosions, aiding, thereby, in diagnosis of the underlying causes of nursing difficulties. Improved wound surveillance and standardization for purposes of research documentation are additional benefits anticipated with the use of breast dermoscopy.
  
  
  
  We conclude that real-time, high-quality, magnified imaging of the lactating breast represents a recognizable advance in pursuit of a rapid and accurate technique that aids in the identification of the factors responsible for lesions affecting nursing women. Moreover, it features an already existing technology requiring little training at a reasonable cost.
authors.affiliation: 1 Department of Family Medicine, Sial Family Medicine and Primary Care Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel .|2 Community Pediatric Service, Kedumim Family Health Center , Clalit Health Services, Lev Shomron, Israel .|3 Elon Moreh Clinic , Clalit Health Services, Lev Shomron, Israel .
authors.forename: Sody A
authors.initials: SA
authors.lastname: Naimer
authors.affiliation: 4 Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel .
authors.forename: William F
authors.initials: WF
authors.lastname: Silverman
mesh_terms: D001942:Breast Feeding / Q000009:adverse effects*; D046169:Dermoscopy; D004867:Equipment Design; D005260:Female; D006801:Humans; D022125:Lacerations / Q000000981:diagnostic imaging*; D007774:Lactation; D008413:Mastitis / Q000000981:diagnostic imaging*; D009558:Nipples / Q000293:injuries* / Q000503:physiopathology; D010146:Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D010808:Physical Examination; D012883:Skin Ulcer / Q000000981:diagnostic imaging*