Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obervation Letter
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF
Letter to the Editor
2014:80:6;540-542
doi: 10.4103/0378-6323.144181
PMID: 25382515

Ipsilateral galactorrhea following zoster of the T4 dermatome

Nidhi Jindal1 , VK Jain1 , Sameer Aggarwal2 , Sarabjit Kaur1
1 Departments of Dermatology and Venereology, Pt. Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
2 Department of Endocrinology, Pt. Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India

Correspondence Address:
Nidhi Jindal
HNo 1151, Sector 2, HUDA, Rohtak - 124 001, Haryana
India
How to cite this article:
Jindal N, Jain V K, Aggarwal S, Kaur S. Ipsilateral galactorrhea following zoster of the T4 dermatome . Indian J Dermatol Venereol Leprol 2014;80:540-542
Copyright: (C)2014 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Galactorrhea is defined as discharge of milk or milk-like secretion from the breast in the absence of parturition or beyond six months′ postpartum in a non-breastfeeding woman. [1] The secretion may be intermittent or persistent, scant or abundant, free flowing or expressible, and unilateral or bilateral. It is a relatively common problem that occurs in approximately 20% to 25% of women. [1] Herpes zoster is a rarely implicated cause for galactorrhea.

A 50-year-old postmenopausal woman with milky discharge from her right breast and pain in the right side of chest for the previous 6 months was referred from the endocrinology department. The pain was continuous, of moderate intensity, burning in nature, and associated with hyperesthesia. She had a painful vesicular eruption in the area of right breast extending up to the scapula, 12 months ago. She had no history of headache, vomiting, or decreased vision and did not take any medication except analgesics for the chest pain. Examination revealed an irregular hypopigmented atrophic patch on the right side of the chest wall extending over the right scapula in T4 dermatome [Figure - 1]. Breast examination showed no asymmetry, dimpling, or masses but did reveal a milky discharge from the right nipple. Screening biochemical investigations, thyroid function test, and serum prolactin levels were within the normal range. In the absence of systemic signs, we chose not to undertake a battery of other tests for galactorrhea, viz. serum cortisol, growth hormone, serum insulin-like growth factor levels, and imaging studies.

Figure 1: Atrophic hypopigmented scars right side, T4 dermatome

Pain was managed with pregabalin and analgesics. For galactorrhea, she was referred to the endocrinology department where she was advised periodic assessment of serum prolactin levels as patients with isolated galactorrhea and normal prolactin levels do not require treatment if they are not bothered by the milky discharge. [1] Her serum prolactin levels on the first follow-up visit were normal and she was advised to report after another 6 months.

The history of a painful vesicular eruption and the presence of atrophic scars within a dermatome are evidence for zoster which occurred 6 months prior to the development of galactorrhea and was the possible cause, in the absence of another explanation and with normal laboratory investigations. Complications of herpes zoster can be classified into four categories according to the affected system: cutaneous, ocular, neurological, and visceral. [2] Galactorrhea is seldom described as a complication of zoster and we found only two previous reports. [3],[4],[] One case was similar to ours, whereas the other was a HIV-positive postmenopausal woman with persistent galactorrhea. The time gap between zoster and galactorrhea in one case was 6 months while it was 2 months in the other patient. [3],[4]

Galactorrhea is a benign nipple discharge that has no association with breast cancer. It is not a disease process but is a symptom that may or may not be associated with an underlying disease that needs further medical treatment. Galactorrhea is idiopathic in about 35% of cases, physiological in 14%, and occurs as a result of chest wall irritation in less than 10%. Zoster is a rarely cited cause of galactorrhea and may be mediated by stimuli sent through intercostal nerves to the posterior column of the spinal cord, to the mesencephalon, and finally to the hypothalamus, where the secretion of prolactin inhibitory factor is reduced, thereby increasing the levels of prolactin and leading to galactorrhea. [1]

References
1.
Leung AK, Pacaud D. Diagnosis and management of galactorrhea. Am Fam Physician 2004;70:543-50.
[Google Scholar]
2.
Kutlubay Z, Goksugur N, Engin B, Tuzun Y. Complications of Zoster. J Turk Acad Dermatol 2011;5:1-7.
[Google Scholar]
3.
Paul TV, Spurgeon R, Jebasingh F. Visual vignette. Postherpetic neuralgia and galactorrhea. Endocr Pract 2008;14:392.
[Google Scholar]
4.
Bateganya MH, Muhwezi J, Mugyenyi P, Kityo C, Lynen L, Zolfo M, Colebenders R. Persistent galactorrhea in a post menopausal woman with Herpes zosterand HIV-1 infection. Malawi Med J 2005;17:101-3.
[Google Scholar]

Fulltext Views
225

PDF downloads
138
Show Sections