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Juvenile Colloid Milium
Colloid Milium Juvenile

Presentation

We present the case of a 16-yearold Yemeni boy with juvenile colloid milium, who presented with an unusual variant of juvenile colloid milium with waxy transparent papules on the helices which resembled a cutaneous horn. [avensonline.org]

In this case report, we present a 52-year-old man who presented with a nodule on his upper lip that mistakenly was diagnosed and treated as keloid. Read More Unusual Manifestations of Familial Juvenile Colloid Milium in Two Siblings. [pubfacts.com]

It presents as flesh-coloured or yellow papules. [elsevier.es]

In this case report we present a case of colloid milium in a 55 years old male with verrucous violaceous colloid milium on the dorsum of both hands, face, and ears. [article.sapub.org]

Entire Body System

  • 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. vol. 142. 2006. pp. 784-5. (A case vignette that describes how colloid milium can be misdiagnosed as nodular amyloidosis.) [dermatologyadvisor.com]

  • 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]

    An 11-year-old male with no siblings and without any relevant medical history or consanguinity was referred to our clinic with multiple, asymptomatic lesions on his face and extremities. [jaad.org]

    […] fair-skinned men with a history of prolonged sun exposure and chronic exposure to petroleum products.2,3 Lesions are located primarily in sun-exposed areas, such as the nose, ears, neck, periorbital region, and dorsa of the hands.4 The lesions are usually asymptomatic [consultant360.com]

    Case Report A 31-year-old man was referred to our clinic for asymptomatic papules on one side of his face that had been present for 31 months. [escholarship.org]

    Case Report A 55 years old male presented with asymptomatic pigmented verrucous firm papules coalescent to plague on the dorsum of both hands with firm violaceous papules on the forehead, eyelids and ears for 35 years figure (1). [article.sapub.org]

  • Inflammation

    […] include: Deposits of homogenous, amorphous, faintly eosinophilic material with dividing clefts and fissures, which extend into the papillary and mid-dermis [2,3] Fibroblasts lining the clefts, which can contain lymphocytes and mast cells [12] Lack of inflammation [dermnetnz.org]

    There is no inflammation, but a few lymphocytes and mast cells may be present. Colloid milium is positive for periodic acid-Schiff stain and can show green birefringence with Congo Red stain. [dermatologyadvisor.com]

  • Weakness

    In ACM and NCD, Congo-red stain is positive and results in green birefringence sometimes with weak reaction. [idoj.in]

Jaw & Teeth

  • Periodontitis

    There are usually no systemic implications, with the exception of a rare ligneous conjunctivitis or periodontitis in the juvenile type. [moh-it.pure.elsevier.com]

    Unusual involvements have also been reported, with nodular colloid milium located on the conjunctiva and anterior orbit (15), upper eyelid (16), the oral cavity (17) or in association with ligneous conjunctivitis or periodontitis (5). [ncbi.nlm.nih.gov]

Skin

  • Skin Lesion

    Figure 5: Focally atrophic squamous epithelium Histopathological examination of skin lesions showed dystrophic calcification in epidermal and subepidermal zone [Fig. 6]. [journals.lww.com]

    Histopathological examination of skin lesions showed dystrophic calcification in epidermal and subepidermal zone [Figure 6]. [ijo.in]

    During same procedure, biopsy of skin lesions was taken and sent for hislopathological examination. [cyberleninka.org]

    Conclusions Colloid milium is a rare disease can be presented with variable and extensive skin lesions on the sun exposed area. References [1] Handfi eld-Jones SE, Atherton D, Black M. Juvenile colloid milium. [article.sapub.org]

  • Skin Disease

    Original language English Title of host publication Clinical and Pathological Aspects of Skin Diseases in Endocrine, Metabolic, Nutritional and Deposition Disease Publisher Springer New York Pages 157-160 Number of pages 4 ISBN (Print) 9781607611806 DOIs [moh-it.pure.elsevier.com]

    There is no family history of such skin disease. Figure 1. [article.sapub.org]

    Calonje JE, Granter SR On DermNet NZ Colloid milium Dermatopathology glossary Dermatopathology index Books about skin diseases Books about the skin Dermatology Made Easy book [dermnetnz.org]

    (eds) Clinical and Pathological Aspects of Skin Diseases in Endocrine, Metabolic, Nutritional and Deposition Disease. [link.springer.com]

  • Sweating

    Atrophy of eccrine sweat glands and involvement of pilosebaceous units are additional features. Unlike colloid milium, there is positive staining for laminin, type IV collagen and cytokeratin. [dermnetnz.org]

  • 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]

    This may include: Milium/milia Sebaceous hyperplasia Syringomas Retention cysts Molluscum contagiosum Systemic and primary cutaneous amyloidosis Steatocystoma multiplex Lipoid proteinosis Calcinosis cutis Cutaneous sarcoidosis Papular mucinosis. [dermnetnz.org]

  • Hyperkeratosis

    (b): Close up view of the area, showing pale pink deposits in the papillary dermis with multiple fibroblasts aligned splitting and fissures along with hyperkeratosis, and atrophic epidermis (H&E X40). [avensonline.org]

    Light microscopy findings were abundant compact hyperkeratosis with patches of parakeratosis, moderate, irregular epidermal acanthosis with areas of elongation and thickening of interpapillary ridges. [elsevier.es]

Psychiatrical

  • Suggestibility

    Clinical and histological findings in our case suggested it to be a nodular variant of adult form of colloid milium. [jpma.org.pk]

    A review of the literature suggests a possible genetic abnormality that leads to sun-induced degeneration of keratinocytes. Similar articles Colloid milium: a final degeneration product of actinic elastoid. Hashimoto K, Black M. Hashimoto K, et al. [pubmed.ncbi.nlm.nih.gov]

    Phenols have been suggested as causative agents. [emedicine.medscape.com]

    The clinical impression suggested Gottron's papules, and after ruling out cutaneous mucinosis, we performed a skin biopsy using a 4.0mm biopsy punch, which was sent for histopathology. [elsevier.es]

    We suggest the long-term sun exposure as an etiologic factor; thus sun protection would be the most preventive and available treatment. [idoj.in]

Workup

The patient underwent a workup, including a complete blood cell count, metabolic profile, erythrocyte sedimentation rate, and serum protein electrophoresis, and the results were all within normal limits. [jamanetwork.com]

Treatment

Although little benefit could be seen after the first and second treatments, the patient showed clear improvement after the third treatment. [jamanetwork.com]

The sun exposure is linked to the pathogenesis and treatment basically is photoprotection. REFERENCES Muscardin M, Bellocci M, Balus L. Papuloverrucous colloid milium: an occupational variant. Br J Dermatol 2000;143:884- 87. [medigraphic.com]

Treatment Options No satisfactory therapies are currently available. Treatment options are summarized in the Table 1. Table 1. [dermatologyadvisor.com]

She was continued with the same treatment and reviewed after 3 months. At this time, the woody membrane over conjunctiva had recurred because definitive treatment with plasminogen could not be started. [journals.lww.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

Discussion Colloid milium is a degenerative change of uncertain etiology, There are three main forms of colloid milium: adult, juvenile and nodular colloid degeneration type [1, 2]. [article.sapub.org]

We suggest the long-term sun exposure as an etiologic factor; thus sun protection would be the most preventive and available treatment. [idoj.in]

Several etiologies have been postulated including chronic exposure to UV light, contact with petroleum products, application of bleaching creams containing hydroquinone, and genetic predisposition [1]. [escholarship.org]

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]

[…] hyperpigmented.2 The male-female ratio is 4:1.4 Colloid milium, which was first described in 1866, was thought to be a result of the degeneration of sebaceous glands.2 Although multiple theories have been proposed regarding the pathogenesis of CM, the exact etiology [jamanetwork.com]

Epidemiology

You might also be interested in Dermatology Occurrence/Epidemiology This section has been translated automatically. Very rare, < 50 cases known in world literature; m:f=1:1; Etiopathogenesis This section has been translated automatically. [altmeyers.org]

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]

Similar to adult colloid milium (ACM), sun exposure appears to be an important factor in inducing such lesions in susceptible pediatric patients, but the two diseases show different pathophysiology and clinicopathological features. [ncbi.nlm.nih.gov]

Prevention

We suggest the long-term sun exposure as an etiologic factor; thus sun protection would be the most preventive and available treatment. [idoj.in]

Protection from the sun and petroleum derivatives is advised, but whether these precautions are actually preventive is still unclear. No follow-up is needed and it is not yet determined if maintenance therapy is required once successfully treated. [dermatologyadvisor.com]

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]

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