Supernumerary nipple

Supernumerary nipple

A supernumerary nipple is an additional nipple occurring in mammals, including humans. They are often mistaken for moles. Studies variously report the prevalence of supernumerary nipples as approximately 1 in 18 and 1 in 40.<ref name="Study1">[ https://link.springer.com/article/10.1007/s004310050944], Supernumerary nipples: prevalence, size, sex and side predilection – a prospective clinical study, H. Schmidt, European Journal of Pediatrics volume 157, pages 821–823 (1998).</ref><ref name="Study2">[ https://jamanetwork.com/journals/jamapediatrics/article-abstract/511138], 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.</ref><ref name="Bolognia"/>

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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.<ref>Kajava Y. "The proportions of supernumerary nipples in the Finnish population". Duodecim 1915; 1:143-70.</ref><ref name="eMedicine - Revis"> Revis, Don R. Jr.. Breast Embryology(link). {{{website}}}.

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Types

Type	Glandular tissue	Nipple	Areola	Fat tissue	Hair patch
1	yes	yes	yes	yes
2	yes	yes
3	yes		yes
4	yes
5 ("pseudomamma")		yes	yes	yes
6 ("polythelia")		yes
7 ("polythelia areolaris")			yes
8 ("polythelia pilosa")					yes<ref>Camacho F., Polythelia pilosa: A Particular Form of Accessory Mammary Tissue, Dermatology, 1998, Vol. 196(Issue: 3), pp. 295–298, DOI: 10.1159/000017924, PMID: 9621135,</ref>

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.<ref name="Pseudomamma on the foot: An unusual presentation of supernumerary breast tissue">

Pseudomamma on the foot: An unusual presentation of supernumerary breast tissue(link). '.

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A possible relationship with mitral valve prolapse has been proposed.<ref name="pmid10980229">,

 Supernumerary nipple as a cutaneous marker of mitral valve prolapse in Asian Indians, 
 Am. J. Cardiol., 
 2000,
 Vol. 86(Issue: 6),
 pp. 695–697,
 DOI: 10.1016/S0002-9149(00)01057-2,
 PMID: 10980229,</ref>

Clinical significance

Clinical presentation

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:

• McKusick–Kaufman syndrome
• Char syndrome
• Simpson-Golabi-Behmel syndrome

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.<ref>Throwback | First Cut: The Triple Nipple Club | Free Video Clips from Channel 4</ref> 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.<ref>Channel 4 - FourDocs blog - First Cut line-up</ref>

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,<ref>AskMen.com - Mark Wahlberg's third nipple love</ref> Lily Allen,<ref>YouTube - Lilly Allen Third Nipple</ref> and Tilda Swinton, as well as well known TV and film characters such as the Bond villain Scaramanga and Chandler Bing.

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 even 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.<ref>Salon | Why do men have nipples?</ref>

See also

• Accessory breast
• Rudimentary supernumerary digit

External links

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