Supernumerary nipple and cardiocutaneous associations: Reply☆

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To the Editor:

The concept of supernumerary nipples (polythelia) with associated cardiovascular disorders was indeed reviewed by our group during the preparation of our manuscript.1 While we may well have overlooked some of the references provided by Urbani (references 2–7), our review of the literature failed to provide convincing, non-anecdotal, age- and sex-controlled studies to justify including polythelia in our definitive list. Just like achrocordons and gastrointestinal polyposis are anecdotally associated, it is our belief that an evaluation of children, with and without polythelia, age- and sex-matched with cardiovascular consultations in all, while expensive and time consuming, is the only way to conclusively prove the association.

I have reviewed Dr Urbani's paper,2 and while the paper suggests an association, I believe more definitive evidence needs to be presented to justify this association.

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References 

1. Abdelmalek NF, Gerber TL, Menter A. Cardiocutaneous syndromes and associations. J Am Acad Dermatol. 2002;46:161–183
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2. Urbani CE, Betti R. Accessory mammary issue in clinical practice. Milan (Italy): McGraw-Hill; 1996;
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