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Nipple rash – Information for GPs

Referral criteria / commissioning position

Refer to secondary care if:

  • not resolved within 2 weeks of good compliance with treatment via ‘two week rule’ (purpose of referral is to exclude Padgets Disease of the Nipple)
  • the condition is clearly part of a more generalized eczema (a dermatology referral may be worth considering)
  • not itchy (referral advised whether involving nipple or not)

Red flag symptoms:

  • Associated lump, ulceration, skin distortion, unilateral nipple discharge

Investigations prior to referral

  • Assess for other manifestations of skin disease

Information to include in referral letter

  • Duration of symptoms
  • Details of treatments and measures tried including outcomes
  • Drug history (prescribed and non-prescribed)
  • Relevant past medical/surgical history
  • Current regular medication
  • BMI
  • Smoking status
  • Alcohol consumption

Patient information

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