The ducts produce an irritating fluid that results in periductal inflammation, nipple eversion, and sometimes a mass. Often bilateral and accompanied by burning or itching. Paget's disease also causes an eczemoid nipple with tingling, itching and burning. Elevated prolactin level is common. Document and FU as for breast mass.
Surgical excision is required.
Oral contraceptives may cause clear or milky discharge. Psychotropic drugs, stimulation and hyperprolactinemia also cause galactorrhea. PRL level is indicated for nonlactating women. If PRL is elevated and the patient is on a drug thought to cause hyperprolactinemia, then discontinue the drug and repeat PRL in one month. If unable to discontinue the drug , then do hyperprolactinemia workup.