A milium is a small, superficial, keratin-filled cyst. Most patients present with multiple cysts and are thus diagnosed with milia.
Presentation
Milia are off-white or pearly, superficial lesions that generally measure less than 3 mm in diameter [5]. They are slightly raised above the skin surface.
With regards to the single entities, the following shall be stated:
- Congenital milia may indicate more severe pathologies, e.g., Bazex-Dupré-Christol syndrome, Brooke–Spiegler syndrome, oral-facial-digital syndrome type I, pachyonychia congenita [3] [6]. Accordingly, neonates may present with the respective developmental defects.
- Many neonates develop primary milia not associated with hereditary disorders [3] [7]. There are usually multiple lesions around the nose and in other facial areas, but the neonate's trunk and extremities may also be affected. Spontaneous remission is to be expected.
- Juvenile and adult milia largely resemble those observed in neonates and are very common. However, the condition is usually more persistent and it may take longer until spontaneous remission occurs. Predilection sites are periorbital regions, cheeks, nose, forehead and chest.
- Individuals affected by milia en plaque present with multiple milia grouped on an erythematous plaque [8]. Patients suffering from discoid lupus erythematosus, lichen planus, or pseudoxanthoma elasticum have been suggested to be predisposed to this type of milia. Milia en plaque commonly manifest in the head and neck region, especially in periauricular, periorbital and nose areas.
- Multiple eruptive milia may be diagnosed if patients report the unexplained appearance of crops of milia within a short period of time [9]. Head, neck, and trunk are most frequently affected.
Entire Body System
- Inflammation
This condition causes redness, swelling, and pain (also known as inflammation). [healthline.com]
Right shoulder inflammation. June 22, 2018 Atlanta Braves placed RHP Mike Soroka on the 10-day disabled list retroactive to June 20, 2018. Right shoulder inflammation. [milb.com]
People have a tendency to be too aggressive in trying to remove debris and end up causing a lot of inflammation, which makes things worse. [amazon.com]
- Falling
Unaware of this, Milia finds herself falling in love with her father. [imdb.com]
Cash US dollars fall from above to a cache of weapons and drugs StockSeller_ukr/Getty Images Passing Bullets On Table RockfordMedia/Getty Images Asian sportsmen is falling down on the ground while doing stunt aleksejplatonov/Getty Images Fuel Pump Counting [youtube.com]
Bloom Time: Late spring Flower Height: 40 cm Foliage Height: 30 cm Grass Type: Cool Season Interesting Notes: Cool Season Grasses: These grasses do the majority of their growing in early spring and start again when temperatures start to cool in the fall [connonnurseries.com]
The glumes (chaffy bracts that surround the seed) remain attached to the plant after the seeds fall. DISTRIBUTION: Milium is widespread in Eurasia. In North America, it has been reported only in the indicated Idaho counties. [co.power.id.us]
- Fever
Children's paracetamol can bring down a fever. [nhs.uk]
Other symptoms of meningitis include a fever, sleepiness, floppiness, unusual crying and your baby becoming unresponsive (Newson 2016, NICE 2016a). [babycentre.co.uk]
See Also: military march military pace military pentathlon military police military school military science military-industrial complex militate militia militiaman milium milk milk adder milk bank milk bar milk bench milk chocolate milk cow milk fever [wordreference.com]
In the first few months of a baby's life, any rash associated with other symptoms (such as fever, poor feeding, lethargy, cough ) needs to be evaluated by a pediatrician as soon as possible. [rxlist.com]
- Surgical Procedure
“Removing them requires a small surgical procedure that even aestheticians are not allowed to perform because it requires truly going beneath the skin surface.” [bustle.com]
Medical Treatment Surgical Procedures Physical Modalities Topical exfoliating agents No benefit Fractional laser resurfacing Systemic ascorbic acid Erbium: YAG ablative laser resurfacing Dermabrasion Cryotherapy Chemical peels There is no evidence that [infectiousdiseaseadvisor.com]
Treatment options for colloid milium Medical Treatment Surgical Procedures Physical Modalities Topical exfoliating agents No benefit Fractional laser resurfacing Systemic ascorbic acid Erbium: YAG ablative laser resurfacing Dermabrasion Cryotherapy Chemical [clinicaladvisor.com]
- Infertility
She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative. [news-medical.net]
Skin
- Papule
In addition to the typical translucent papules seen on the forehead, there were warty papules on the backs of both hands with unusual histological and ultrastructural features: marked hyperplasia of the epidermis with orthokeratotic hyperkeratosis and [ncbi.nlm.nih.gov]
Colloid milium is an unusual cutaneous disorder characterized by multiple cystic papules. It is a degenerative process in which the papules are located on the photoexposed areas. [histopathology-india.net]
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. [advbiores.net]
- Eruptions
Multiple eruptive milia may be diagnosed if patients report the unexplained appearance of crops of milia within a short period of time. Head, neck, and trunk are most frequently affected. Milia are diagnosed clinically. [symptoma.com]
Eruptive hidradenoma and syringoma: histological, histochemical, and electron microscopie studies. Arch Dermatol. 1967; 96: 500–519 View in Article | Crossref | PubMed | Scopus (78) | Google Scholar 3.Hashimoto, K, Blum, D, Fukaya, T, and Eto, H. [jaad.org]
Multiple eruptive milia and milia en plaque are rare entities. Race No racial predilection is recognized for milia. Sex Sexual prevalence is equal for primary and secondary milia. Eruptive milia and milia en plaque occur more frequently in women. [emedicine.medscape.com]
Multiple Eruptive Milia Multiple eruptive milia (MEM) is another rare variant in which lesions come up quickly, over the face or the trunk. In some cases, it is associated with other skin syndromes such as the multiple trichoepithelial syndrome. [news-medical.net]
A common method that a dermatologist uses to remove a milium is to nick the skin with a #11 surgical blade and then use a comedone extractor to press the cyst out.[4] See also[edit] Eruptive vellus hair cyst Sebaceous hyperplasia Seborrheic keratosis [en.wikipedia.org]
- Skin Disease
Clinical and Pathological Aspects of Skin Diseases in Endocrine, Metabolic, Nutritional and Deposition Disease. [moh-it.pure.elsevier.com]
On DermNet NZ Cysts Other websites Milia – Medscape Reference Books about skin diseases Books about the skin Dermatology Made Easy book [dermnetnz.org]
They may appear as a primary condition or be secondary to skin trauma, skin inflammations, skin disease or some medications. Milia (Milium) - pimples around eye on skin. [news-medical.net]
- Skin Lesion
They include: Cryotherapy: a type of treatment that freezes skin lesions. Where a patch of skin has changed in appearance, it is known as a skin lesion. Laser treatment. Dermabrasion: a procedure that removes the topmost layers of the affected skin. [patient.info]
Skin distribution of colloid milium lesions The lesions occur on light-exposed skin, with the cheeks, periorbital area, nose, ears, and neck most frequently involved; however, lesions may also occur on the backs of the hands and forearms. [emedicine.medscape.com]
The skin lesions clinically suggested milia. 报告1例表现为粟丘疹的汗管瘤。 2. Four cases of milia en plaque are reported. 报告4例斑块状粟丘疹。 2) milium [英]['miliəm] [美]['mɪlɪəm] 粟丘疹 1. [dictall.com]
Your doctor will examine your skin to determine if you have milia based on the appearance of the cysts. Skin lesion biopsies are only needed in rare cases. There’s no treatment necessary for infant milia. [healthline.com]
- Hyperkeratosis
In addition to the typical translucent papules seen on the forehead, there were warty papules on the backs of both hands with unusual histological and ultrastructural features: marked hyperplasia of the epidermis with orthokeratotic hyperkeratosis and [ncbi.nlm.nih.gov]
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]
Antinuclear antibodies (ANA) + Endomysial antibodies + Antibodies aganist neutrophilic cytoplasm (ANCA) + Non-tumorous skin diseases + Diseases of the Epidermis + Ichthyosis + Ichthyosis vulgaris + Ichthyosis lamellaris + X-linked ichthyosis + Epidermolytic hyperkeratosis [atlases.muni.cz]
Psychiatrical
- Suggestibility
These findings suggested that juvenile colloid milium is different from adult colloid milium despite clinical similarities and that the former belongs to the group of actinic amyloid K, i.e. amyloidoses due to actinic degeneration of keratinocyte and [ncbi.nlm.nih.gov]
In the rare type of milia called milia en plaque, certain creams such as isotretinoin or tretinoin are sometimes suggested as treatment, or the antibiotic tablet, minocycline. [patient.info]
- Fidgeting
The only time I fidgeted in my seat was the "merci" scene when hungry kids are asked to imagine food in their empty bowls and give thanks (another political/religious metaphor?). It goes on for too long. [imdb.com]
Neurologic
- Irritability
Pat your face dry, and rinse with lukewarm water to wash away any irritants before you step out of the steamy room. Gentle skin exfoliation might help keep your skin free of irritants that cause milia. [healthline.com]
This means that trying to pop or push them out just irritates the skin around them, which can increase your risk of skin infection and permanent scarring. [theprettypimple.com]
Rough sheets or clothing may irritate the skin and mild reddening around the bump. The middle of the bump will stay white. Irritated milia are sometimes called "baby acne." This is incorrect since milia are not a true from of acne. [medlineplus.gov]
They can become irritated and make them red in color along the edges and white in the middle. Treatment There is no treatment necessary for most cases of milia as they usually clear up on their own. [metrin.com]
- Confusion
Milia can also be confused with stubborn whiteheads. In children, milia often disappear within two to four weeks. For adults, they can be removed by a physician (a dermatologist will have specialist knowledge in this area). [hilarispublisher.com]
Milia can also be confused with stubborn whiteheads. In children, milia often disappear within two to four weeks. For adults, they can be removed by a physician (a dermatologist will have specialist knowledge in this area). Milium [omicsonline.org]
Known as 'milia', these small bumps are not to be confused with acne or whiteheads, explains Dr Ross Perry, Medical Director of Cosmedics. [glamourmagazine.co.uk]
Because they are traditionally associated with babies (and usually fade away within a few weeks of birth), milia can cause confusion with adults. [cosmeticclinicpoole.com]
Milia can also be confused with stubborn whiteheads. In children, milia often disappear within two to four weeks. For adults, they can be removed by a physician (a dermatologist has specialist knowledge in this area). [en.wikipedia.org]
- Seizure
Although border apprehensions have dipped significantly since last summer, the Rio Grande Valley continues to be the busiest Border Patrol sector for unauthorized crossings and drug seizures, according to Customs and Border Protection statistics. [texastribune.org]
Such patients can also have seizures due to vasculitis or lupus inflammation. Kidney failure is a common complication of lupus and scleroderma. [healthline.com]
Workup
Milia are diagnosed clinically. A small incision into the lesion allows for the expression of keratinous material, which confirms the established visual diagnosis [10]. Although not usually required, tissue samples may be obtained for histopathological analyses. Microscopically, milia correspond to epidermal, keratin-filled cysts delimited by several layers of stratified squamous epithelium. These cysts originate in the infundibulum of the hair follicle. In the case of milia en plaque, immune cell infiltrates can be observed in close proximity to milia [8].
Treatment
Although little benefit could be seen after the first and second treatments, the patient showed clear improvement after the third treatment. [jamanetwork.com]
Milium - treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!! [medicine-for-you.com]
Share on Pinterest Milia in babies usually clears up over time without treatment. Image credit: Serephine, 2011 Some cases of milia clear up without any treatment within a few months. [medicalnewstoday.com]
Prognosis
[…] milium is rare, and we report this case to increase knowledge and management regarding this rare disease and to differentiate it from other diseases such as amyloidosis, lipoid proteinosis, plasmacytoma, and conjunctival lymphoma, which carry a graver prognosis [ncbi.nlm.nih.gov]
[…] definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis, and additional useful information HERE. [dovemed.com]
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
They stated the belief that sunlight is an important factor in the etiology of this condition. [jamanetwork.com]
CONCLUSION: The etiologic significance of this condition is unknown. Potential sources of the material and a discussion of the differential diagnosis follow. [ncbi.nlm.nih.gov]
Although they are very common, evidence regarding their etiology and pathogenesis is scarce. This particularly applies to primary milia, which arise spontaneously. [symptoma.com]
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]
Pathophysiology Retention of keratin and sebaceous material within the pilosebaceous duct, eccrine sweat duct, or sebaceous collar surrounding fine vellus hair Etiology Most commonly spontaneous in newborns May be related to trauma or blistering conditions [unboundmedicine.com]
Epidemiology
Epidemiology Frequency Colloid milium is rare, but more than 100 case reports are present in the world literature. No known figures exist on prevalence. Race Colloid milium is more common in fair-skinned individuals. [emedicine.medscape.com]
The co-ordinating centre is based in the Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford. [millionwomenstudy.org]
Primary: spontaneous Secondary: secondary to trauma, medications, or another disease Milia en plaque—rare type of primary milia which typically occurs in the posterior auricular area as an erythematous plaque Epidemiology Congenital milia is the most [unboundmedicine.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]
Pathophysiology Retention of keratin and sebaceous material within the pilosebaceous duct, eccrine sweat duct, or sebaceous collar surrounding fine vellus hair Etiology Most commonly spontaneous in newborns May be related to trauma or blistering conditions [unboundmedicine.com]
Pathophysiology The most established theory argues that the colloid deposits are secondary to elastic fiber degeneration. [infectiousdiseaseadvisor.com]
Prevention
Ways to prevent milia As ever with skincare, prevention is better than cure (there’s no needles involved, for one), so try these suggestions if milia is a recurring concern for you. 1. [harpersbazaar.com]
Keep reading to find out some of the products I used to help self-treat milia, and what I use to prevent it from making a comeback later down the road. Amazon. [stylecaster.com]
About Million Hearts® 2022 Million Hearts® 2022 is a national initiative co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS)external icon to prevent 1 million heart attacks and strokes [millionhearts.hhs.gov]
[…] deaths from heart attack Prevent Adverse Drug Events (ADEs) by implementing medication reconciliation Prevent Central Line Infections by implementing a series of interdependent, scientifically grounded steps called the "Central Line Bundle" Prevent Surgical [ihi.org]
It is not always possible to prevent milia, for example, when they occur in newborns. However, when milia are associated with other skin conditions or injuries, swift treatment may keep them from appearing. [medicalnewstoday.com]
Summary
A milium is a single, superficial, keratin-filled cyst. However, few patients present with solitary lesions and thus, research papers and case reports usually refer to milia. Besides cosmetic issues, milia are benign and not known to be associated with morbidity and mortality. Although they are very common, evidence regarding their etiology and pathogenesis is scarce. This particularly applies to primary milia, which arise spontaneously. In contrast, secondary milia develop after trauma, on sunburned skin, or sites affected by dermatological conditions related to the presence of blisters and bullae. The topical application of corticosteroids has also been related to the onset of milia [1]. Milia have been reported to develop after radiotherapy [2].
The following types of milia may be distinguished:
- Congenital milia
- Neonatal, juvenile, and adult-onset milia
- Milia en plaque
- Multiple eruptive milia
- Trauma-associated milia
Of note, Epstein pearls and Bohn's nodules, i.e., gingival and palatal cysts, display certain similarities to milia and have repeatedly been referred to as the oral counterparts of the cutaneous condition. However, Spanish researchers could not confirm the association between the respective disorders [3] and they should be treated as individual entities [4].
References
- Tsuji T, Kadoya A, Tanaka R, Kono T, Hamada T. Milia induced by corticosteroids. Arch Dermatol. 1986;122(2):139-140.
- Lee A, Griffiths WA. Multiple milia due to radiotherapy. J Dermatolog Treat. 2002;13(3):147-149.
- Monteagudo B, Labandeira J, Cabanillas M, Acevedo A, Leon-Muinos E, Toribio J. Prevalence of milia and palatal and gingival cysts in Spanish newborns. Pediatr Dermatol. 2012;29(3):301-305.
- Lewis DM. Bohn's nodules, Epstein's pearls, and gingival cysts of the newborn: a new etiology and classification. J Okla Dent Assoc. 2010;101(3):32-33.
- Berk DR, Bayliss SJ. Milia: a review and classification. J Am Acad Dermatol. 2008;59(6):1050-1063.
- Rutter KJ, Judge MR. Profuse congenital milia in a family. Pediatr Dermatol. 2009;26(1):62-64.
- Kansal NK, Agarwal S. Neonatal milia. Indian Pediatr. 2015;52(8):723-724.
- Terui H, Hashimoto A, Yamasaki K, Aiba S. Milia En Plaque as a Distinct Follicular Hamartoma With Cystic Trichoepitheliomatous Features. Am J Dermatopathol. 2016;38(3):212-217.
- Gonul M, Benar H, Gokce A. Multiple eruptive milia on scalp. J Eur Acad Dermatol Venereol. 2015.
- Zuber TJ. Minimal excision technique for epidermoid (sebaceous) cysts. Am Fam Physician. 2002;65(7):1409-1412, 1417-1408, 1420.