Thelalgia in man is a very rare and intractable pain syndrome of the areola-nipple complex. We describe a 42-year-old man with severe thelalgia since puberty who was successfully treated with local injections of botulinum toxin A.
A 42-year-old man presented with severe bilateral dysesthesia of the papilla and areola mammae since puberty. He had persistent stabbing pain triggered by slight touch or exposure to cold. His medical history revealed liposuction of both breasts 4 years previously and subcutaneous mastectomy 1 year later because of pseudogynecomastia. Repeated local application of topical anesthetics did not relieve the pain.
Eigelshoven S, Kruse R, Rauch L, Hanneken S, Ruzicka T, Neumann NJ. Thelalgia in Man: Successful Treatment With Botulinum Toxin. Arch Dermatol. 2006;142(9):1231-1244. doi:10.1001/archderm.142.9.1242