The FP explained that these were Montgomery tubercles. These brown papules on and around the areola are caused by hypertrophy of the normal sebaceous glands. She explained to the patient that this is a normal occurrence in some pregnant women and nothing to worry about. She noted that they would likely diminish after the pregnancy was over. The FP emphasized that they would not cause any harm to her or her new baby.
Similar types of sebaceous hyperplasia that may worry patients include Fordyce spots found on the lips and the genitals. These, too, are normal and the principal treatment is reassurance.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux, EJ. Skin findings in pregnancy. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013: 462.466.
To learn more about the Color Atlas of Family Medicine, see: http://www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/
You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking this link: http://usatinemedia.com/