A 23-year-old woman presented with questions about the papules present on both her areolae, which had become more prominent after a recent pregnancy. Her husband had noticed them and had expressed concern about whether they might represent serious disease.
Both the patient and her husband had squeezed the papules and in the process had expressed a small amount of white, pasty material from them. They also noted that from time to time, the occasional papule would become a bit red and inflamed for a day or two, then return to normal.
The patient otherwise was in good health, having experienced an uncomplicated pregnancy and delivery. She had been nursing the infant without any problems.
On physical examination, several soft, white papules measuring 1 to 2 mm were uniformly and symmetrically distributed on both areolae. One or two papules also were seen on the nipples themselves. The breasts otherwise were quite normal to inspection and palpation.
Discussion. Visible areolar papules were first described by Irish obstetrician William Fetherstone Montgomery in 1837 and thereafter were called glands of Montgomery. In modern times, the papules still are called Montgomery glands or Montgomery tubercles. Histologic studies have long since confirmed the benign nature of these structures, which represent sebaceous glands that are very similar to those found on other areas such as the scrotum, the penis, and labia minora. The glands supply the skin with sebum and are visible primarily because of the very thin nature of the skin in these areas.
Small amounts of white, pasty material can be expressed from areolar glands with digital manipulation, although the material reforms very quickly. On occasion, they can become slightly inflamed. These structures can become enlarged during pregnancy. The number of these structures on the areola can vary greatly, from none to more than 20.
Treatment is almost never necessary, since areolar glands do not represent a pathologic condition. They can be removed or destroyed surgically, by laser, or by electrodessication.
Outcome of the case. Their main significance of Montgomery glands is well illustrated by this typical case, in which the patient and her husband raised concern and were greatly reassured by examining practitioner’s providing the facts about the benign nature of areolar glands.