supernumerary nipple

{{Short description|Occurrence of an additional nipple in mammals}}

{{Infobox medical condition (new)

| name = Supernumerary nipple

| synonyms = Third nipple, triple nipple, accessory nipple,{{cite book |author=Rapini, Ronald P. |author2=Bolognia, Jean L. |author3=Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |isbn=978-1-4160-2999-1 }} polythelia

| field = Medical genetics, dermatology

| image = Trzeci sutek.jpg

| caption =

| pronounce =

| symptoms =

| complications =

| onset =

| duration =

| types =

| causes =

| risks =

| diagnosis =

| differential =

| prevention =

| treatment =

| medication =

| prognosis =

| frequency =

| deaths =

}}

A supernumerary nipple is an additional instance of nipple occurring in mammals, including humans and monkeys. They are often mistaken for moles. Studies variously report the prevalence of supernumerary nipples as approximately 1 in 18 and 1 in 40.[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).[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.

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.Kajava Y. "The proportions of supernumerary nipples in the Finnish population". Duodecim 1915; 1:143-70.{{cite web |author=Revis |first=Don R. Jr. |title=Breast Embryology |url=http://www.emedicine.com/plastic/topic214.htm |url-access=registration |url-status=live |archive-url=https://web.archive.org/web/20081222221728/https://emedicine.medscape.com/article/1275146-overview |archive-date=22 December 2008 |access-date=3 December 2007 |work=eMedicine}}

Types

Type	Glandular tissue	Nipple	Areola	Fat tissue	Hair patch
class="wikitable"
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{{cite journal \|title=Polythelia pilosa: A Particular Form of Accessory Mammary Tissue \| author=Camacho F. \| author2=González-Cámpora R. \| journal= Dermatology \|volume=196 \|issue=3 \|pages=295–298 \|doi=10.1159/000017924 \|pmid=9621135 \|year=1998 \| s2cid=25211741 }}

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.{{cite journal |url=http://dermatology.cdlib.org/124/case_presentations/pseudomamma/conde.html |title=Pseudomamma on the foot: An unusual presentation of supernumerary breast tissue |year=2006 |doi=10.5070/D339n411b8 |access-date=3 December 2007 |last1=Conde |first1=Délio Marques |last2=Kashimoto |first2=Eiji |last3=Torresan |first3=Renato Zocchio |last4=Alvarenga |first4=Marcelo |journal=Dermatology Online Journal |volume=12 |issue=4 |page=7 |pmid=17083862 |url-access=subscription }}

Clinical significance

=Clinical presentation=

It 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:

A possible connection with mitral valve prolapse has been proposed.{{cite journal |vauthors=Rajaratnam K, Kumar PD, Sahasranam KV |title=Supernumerary nipple as a cutaneous marker of mitral valve prolapse in Asian Indians |journal=Am. J. Cardiol. |volume=86 |issue=6 |pages=695–697 |year=2000 |pmid=10980229 |doi=10.1016/S0002-9149(00)01057-2}}

=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.[https://web.archive.org/web/20080913235353/http://www.channel4.com/video/first-cut-the-triple-nipple-club/series-1/episode-1/throwback_p_1.html Throwback | First Cut: The Triple Nipple Club | Free Video Clips from Channel 4] 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.[http://www.channel4.com/blogs/page/fourdocs?entry=first_cut_line_up Channel 4 - FourDocs blog - First Cut line-up] 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,[https://web.archive.org/web/20080226184353/http://www.askmen.com:80/gossip/mark-wahlberg/mark-wahlberg-third-nipple-love.html AskMen.com - Mark Wahlberg's third nipple love] Lily Allen,[https://www.youtube.com/watch?v=0JbieSOsMIk YouTube - Lilly Allen Third Nipple] and Tilda Swinton, as well as TV and film characters such as the James Bond villain Francisco Scaramanga and Chandler Bing from Friends. 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 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.{{Cite web |last=McCarthy |first=Susan |date=1999-06-08 |title=Why do men have nipples? |url=https://www.salon.com/1999/06/08/nipples/ |url-status=live |archive-url=https://web.archive.org/web/20221205081239/https://www.salon.com/1999/06/08/nipples/ |archive-date=Dec 5, 2022 |access-date= |website=Salon |language=en}}

English pop-star Harry Styles confirmed in 2017 that he has four nipples as a result of the condition.{{Cite web |last=Donahue |first=Rosemary |date=2017-07-19 |title=Harry Styles Has Four Nipples, and That's More Common Than You Think |url=https://www.allure.com/story/harry-styles-confirms-he-has-four-nipples |url-status=live |archive-url=https://web.archive.org/web/20230117005350/https://www.allure.com/story/harry-styles-confirms-he-has-four-nipples |archive-date=2023-01-17 |access-date=2023-01-17 |website=Allure |language=en-US}}