Accessory Nipples
Etiopathogenesis: During the fourth to fifth week of embryogenesis, thickened strips of ectoderm known as
mammary ridges or lines (milk lines) appear, extending from the axilla to the inner side of the thigh . Mammary
buds start to develop as solid, epidermal downgrowths from the mammary ridges during the sixth week of
development. Normally the mammary ridges only persist in the pectoral region where breasts develop with
regression of the rest of the thickened ectodermal streaks. In the case of failure of a complete regression, some
foci may remain, resulting in an accessory nipple.
Clinical Presentation & Diagnosis : Accessory nipples are diagnosed clinically. These nipples are often
overlooked at the first examination of the neonate. They appear as a small pigmented or pearl-coloured marks or as a
concave or umbilicated lesion. These are sometimes noticed in late infancy or childhood but largely remains
undetected. Occasionally, the accessory nipple becomes apparent during puberty, menstruation, or pregnancy when
hormonal change occurs.