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Can postburn itching be a cause of galactorrhea?

Galactorrhea is the discharge of milk or milk-like secretion from the breast in the absence of pregnancy or more than 6 months postpartum, without breastfeeding. Although a common disorder and reported in 20 to 25% women, the literature presents few reports on postburn galactorrhea. Postburn galactorrhea may or may not be accompanied by hyperprolactinemia and there is no consensus in cause and treatment of it. We present a 43-year-old female patient who developed galactorrhea 3 months after chest wall burn injury. The cause of the burn was scalding. Patient was treated by conventional dressing without skin grafting after burn. Her serum prolactin level was normal. Biochemical and pathologic examination of the discharge of the breast was proved as milk. Mammography of the breast was normal. Patient had severe itching complaint. We applied silicon sheet and topical and oral antihistaminics after galactorrhea. Symptoms of the patient were relieved after 2 months of our treatment. We did not need the use of bromocriptin for the treatment of galactorrhea. Galactorrhea after chest wall trauma is not a new entity. Although Morley et al described the relationship between galactorrhea and chest wall injury in 1977, there are no data on galactorrhea after hypertrophic scar. One of the detailed study about galactorrhea after burn injury was presented by Saraiya. According to the study by Saraiya, obese burn patients are more prone and vulnerable for developing galactorrhea. Goyal et al presented six cases with galactorrhea after chest wall burn. According to their study, burn causes wounds and scars, which are hypersensitive, and the stimuli are thought to pass along the intercostal nerves to the posterior column of the spinal cord, to the mesencephalon, and finally to the hypothalamus, which is responsible for the release of the prolactin-inhibiting factor. But, this explanation is inadequate in patients with galactorrhea and normal prolactin level. It should be local factors. In this study, because we treated postburn galactorrhea with the topical application of silicon sheet and antihistaminics, we speculate that continuous stimulations and manual actions due to itching of the hypertrophic scars can be playing a role in the formation of galactorrhea without high level of the prolactin. The occurrence of galactorrhea in chest wall burn injury can be prevented with treatment of hypertrophic scar or itching of the scar in chest wall.