Presentation
It presents as flesh-coloured or yellow papules. [elsevier.es]
In this case report, we present a man with multiple small papules on dorsum of his hands that in pathology confirmed to be colloid milium. [ncbi.nlm.nih.gov]
Prolonged use of hydroquinones has resulted in the development of the pigmented form of colloid milium, sometimes in association with ochronosis. [13] Epidemiology Frequency Colloid milium is rare, but more than 100 case reports are present in the world [emedicine.medscape.com]
Entire Body System
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Amyloidosis
Differential diagnosis of colloid milium Primary cutaneous amyloidosis: Differentiation may be difficult and made only by special stains. In contrast to amyloidosis, colloid milium is negative for laminin and type IV collagen. [dermnetnz.org]
Colloid milium: a histopathologic mimicker of nodular amyloidosis. Arch Dermatol, 142 (2006), pp. 784-785 [3] C. Lim, M. Li. Colloid milium arising on a non-sun exposed area in an adult. Australas J Dermatol, 47 (2006), pp. 137-138 [4] L.M. [elsevier.es]
[…] more extensive over the years, most cases reach their maximum development within 3 years and then remain unchanged.[12] The histological and clinical findings together are unmistakable, although the former alone may be difficult to differentiate from amyloidosis [ncbi.nlm.nih.gov]
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Asymptomatic
At 6-month follow-up, the dermatitis was asymptomatic and showed no signs of change; however, the patient is now willing to try a new approach. [elsevier.es]
CASE REPORT A 38-year-old driver man from Ahvaz, Fitzpatrick skin type III, in otherwise good health was referred to our hospital for asymptomatic papules on dorsal of the hands of 3-year duration. [ncbi.nlm.nih.gov]
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Pain
Onset was marked by pain in the joints of both hands, particularly in the morning, with no stiffness or other symptoms. The patient was referred to the Rheumatology department, and later to our service for diagnosis. [elsevier.es]
Skin
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Photosensitivity
His medical history was negative for photosensitizing medications and disorders. Familial history was negative. A biopsy was taken from one of these lesions, and diagnosis of colloid milium was confirmed. [ncbi.nlm.nih.gov]
Gomes et al.10 report two cases in which they used photodynamic therapy with methyl-aminolevulinate cream as photosensitizer prior to curettage, with no recurrence at the 1-year follow-up visit. [elsevier.es]
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Calcinosis Cutis
Differential diagnosis is with calcinosis cutis, millia cysts, multiple syringoma and amyloidosis.8 There is no consensus on the treatment of choice, and various strategies have been used, including dermabrasion, curettage, cryotherapy, erbium laser resurfacing [elsevier.es]
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Dermatitis
At 6-month follow-up, the dermatitis was asymptomatic and showed no signs of change; however, the patient is now willing to try a new approach. [elsevier.es]
Treatment
Response to topical corticosteroids was poor, and with no improvement the patient decided to suspend treatment. [elsevier.es]
Treatment of colloid milium of the hand by dermabrasion. J Hand Surg Am. 1978;3:98–100. [PubMed] [Google Scholar] [ncbi.nlm.nih.gov]
Fractional photothermolysis for the treatment of adult colloid milium. Arch Dermatol 2007;143:572-4. Lewis AT, Le EH, Quan LT, Krishnan B, et al. Unilateral colloid milium of the arm. J Am Acad Dermatol 2002;46:S5-S7. [medigraphic.com]
Prognosis
Prognosis Colloid milium lesions remain static and do not resolve. Lesions reach their peak within 3 years, after which very few new papules occur. Patient Education Genetic counseling is advisable for the rare juvenile form of colloid milium. [emedicine.medscape.com]
Etiology
Etiology The classic adult and nodular forms of colloid milium are believed to be due to excessive sun exposure, which appears to cause degeneration of elastin. [emedicine.medscape.com]
Epidemiology
Prolonged use of hydroquinones has resulted in the development of the pigmented form of colloid milium, sometimes in association with ochronosis. [13] Epidemiology Frequency Colloid milium is rare, but more than 100 case reports are present in the world [emedicine.medscape.com]
Pathophysiology
The 4 variants are (1) an adult-onset type, (2) a nodular form (nodular colloid degeneration), [1] (3) a juvenile form, [2, 3] and (4) a pigmented form, thought to be due to excess hydroquinone use for skin bleaching. [4] Pathophysiology Colloid milium [emedicine.medscape.com]
Prevention
Exposure to sunlight is thought to be a pivotal factor and could be responsible for the structural damage caused to the elastin, thereby preventing elastin synthesis in fibroblasts. [elsevier.es]