Have I developed a third nipple?
I seem to have developed a third nipple on my chest, which started to weep. My GP prescribed antibiotics, which improved the discharge for a while, but recently the ‘nipple’ has started to bleed quite profusely when I’m in the shower. [I’m 87] Is this dangerous, and what should I do about it?
Dr Roche writes: Interestingly, some people - male and female - are born with extra nipples which occur along a ‘nipple line’, below normal nipples and down over the skin of the abdomen. This would have been present since birth so you should have been aware of it. If it is now bleeding regularly then it needs to be checked and possibly removed.
More likely is a defect in the skin surface which is trapping infection. These can arise from various structures in the skin surface and give rise to an abscess (infected material) or a skin cyst (a fluid-filled space). Both of these can discharge to the surface. If it is bleeding as you describe, then it will need further attention, the concern being that it could represent malignant (cancerous) change. A small skin structure like this is easy to remove in its entirety and this is likely to be the easiest way to resolve the problem and to have the tissue checked and identified by a pathologist.
Too much medication for new type 2 diabetes patient?
My son, aged 43, has just been diagnosed with type 2 diabetes after a blood test. He feels perfectly well and the test was done as a routine health check, but he has been started on lots of medication and is being checked every six months. Isn’t this a bit excessive?
Type 2 diabetes is becoming increasingly common and diagnosed at younger ages than in the past. It occurs gradually and slowly with age and is less likely to need insulin treatment than type 1. The contributing factors are high sugar diets, the increasing body weight of the average person and lack of exercise. We know that the changes leading to this type of diabetes can be present for 5-10 years prior to developing symptoms. At this stage it can be identified on blood tests but the patient will not have any symptoms. By the time symptoms do develop damage to body structures may have already taken place, so diagnosing it early is a definite advantage.
Type 2 diabetes carries with it a markedly increased risk of developing diseases associated with blood vessel damage, such as heart attacks, stroke and poor circulation to the feet. This is because it accelerates the accumulation of cholesterol in the walls of blood vessels and is often associated with high blood pressure. Because of this, strict criteria for the control of cholesterol, blood pressure and the diabetes itself are advised to reduce the long term risks.
Within months of the diagnosis patients often find themselves taking drugs to control blood pressure, blood sugar levels and a statin. There is strong evidence that the increased incidence of blood vessel diseases can be reduced with this approach. However, don’t forget the very great benefits of reducing weight, changing diet and doing more exercise.
Dr David Roche is a GP in Sussex and answers readers’ questions every month in Saga Magazine. He can only answer questions there or on the Saga health website; email your questions to firstname.lastname@example.org and he will answer as many as he can.
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