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Colloid Milium

  • Author: Susan Cooper, MB, ChB, MD, FRCP; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Aug 18, 2015
 

Background

Colloid milium is a rare condition characterized by (1) the presence of multiple, dome-shaped, amber- or flesh-colored papules developing on light-exposed skin and (2) the observance of dermal colloid under light microscopy. 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]

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Pathophysiology

Colloid milium is a degenerative condition linked to excessive sun exposure and possibly exposure to petroleum products and hydroquinone. The origin of the colloid deposition in the dermis is not certain, but it is thought to be due to degeneration of elastic fibers[5, 6] in the adult form and due to degeneration of UV-transformed keratinocytes in the juvenile form. Juvenile colloid milium is inherited.

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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.

Sex

The adult form of colloid milium is more common in males.

Age

The rare juvenile form of colloid milium occurs before puberty. Adult colloid milium is more common in elderly patients.

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Contributor Information and Disclosures
Author

Susan Cooper, MB, ChB, MD, FRCP MRCGP, FRCP, Consultant Dermatologist and Honorary Senior Clinical Lecturer, Department of Dermatology, Churchill Hospital, UK

Susan Cooper, MB, ChB, MD, FRCP is a member of the following medical societies: Royal College of Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Elizabeth J Soilleux, MBBCh, PhD, MA, FRCPath Associate Professor of Pathology, Honorary Senior Clinical Lecturer, NDCLS, Radcliffe Department of Medicine, Oxford University; Consultant Histopathologist, Department of Histopathology, John Radcliffe Hospital, UK

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Marjan Garmyn, MD, PhD Professor, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium; Chair and Adjunct Head, Department of Dermatology, University of Leuven, Belgium

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous coauthor, Ravi Ratnavel, MD, to the development and writing of this article.

References
  1. Patterson JW, Wilkin JK, Schatzki PF. Nodular colloid degeneration: distinctive histochemical and ultrastructural features. Cutis. 1985 Oct. 36(4):355-8. [Medline].

  2. Oskay T, Erdem C, Anadolu R, Peksan Y, Ozsoy N, Gul N. Juvenile colloid milium associated with conjunctival and gingival involvement. J Am Acad Dermatol. 2003 Dec. 49(6):1185-8. [Medline].

  3. Handfield-Jones SE, Atherton DJ, Black MM, Hashimoto K, McKee PH. Juvenile colloid milium: clinical, histological and ultrastructural features. J Cutan Pathol. 1992 Oct. 19(5):434-8. [Medline].

  4. Gonul M, Cakmak SK, Kilic A, Gul U, Heper AO. Pigmented coalescing papules on the dorsa of the hands: pigmented colloid milium associated with exogenous ochronosis. J Dermatol. 2006 Apr. 33(4):287-90. [Medline].

  5. Kobayashi H, Hashimoto K. Colloid and elastic fibre: ultrastructural study on the histogenesis of colloid milium. J Cutan Pathol. 1983 Apr. 10(2):111-22. [Medline].

  6. Hashimoto K, Miller F, Bereston ES. Colloid milium. Histochemical and electron microscopic studies. Arch Dermatol. 1972 May. 105(5):684-94. [Medline].

  7. Muzaffar W, Dar NR, Malik AM. Colloid milium of the upper eyelid margins: a rare presentation. Ophthalmology. 2002 Oct. 109(10):1944-6. [Medline].

  8. Chowdhury MM, Blackford S, Williams S. Juvenile colloid milium associated with ligneous conjunctivitis: report of a case and review of the literature. Clin Exp Dermatol. 2000 Mar. 25(2):138-40. [Medline].

  9. Ojha J, Bhattacharyya I, Islam NM, Wong F, Cohen DM. Colloid milium of the oral cavity: a rare presentation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Apr. 105(4):e34-8. [Medline].

  10. Lewis AT, Le EH, Quan LT, Krishnan B, Schulmeier J, Hsu S. Unilateral colloid milium of the arm. J Am Acad Dermatol. 2002 Feb. 46(2 Suppl Case Reports):S5-7. [Medline].

  11. Innocenzi D, Barduagni F, Cerio R, Wolter M. UV-induced colloid milium. Clin Exp Dermatol. 1993 Jul. 18(4):347-50. [Medline].

  12. Percival GH, Duthie DA. Notes on a case of colloid pseudomilium. Br J Dermatol Syph. 1948 Dec. 60(12):399-404. [Medline].

  13. Martorell-Calatayud A, Balmer N, Sanmartin O, Botella-Estrada R, Requena C, Guillen-Barona C. Familial juvenile colloid milium: report of a well documented case. J Am Acad Dermatol. 2011 Jan. 64(1):203-6. [Medline].

  14. Holzberger PC. Concerning adult colloid milium. Arch Dermatol. 1960 Nov. 82:711-6. [Medline].

  15. Muscardin LM, Bellocci M, Balus L. Papuloverrucous colloid milium: an occupational variant. Br J Dermatol. 2000 Oct. 143(4):884-7. [Medline].

  16. Findlay GH, Morrison JG, Simson IW. Exogenous ochronosis and pigmented colloid milium from hydroquinone bleaching creams. Br J Dermatol. 1975 Dec. 93(6):613-22. [Medline].

  17. Lever WG. Colloid milium and nodular colloid degeneration. Lever's Histopathology of the Skin. 8th ed. Philadelphia, Pa: WB Saunders; 1997. 373-5.

  18. Lai KW, Lambert E, Coleman S, Scott G, Mercurio MG. Nodular amyloidosis: differentiation from colloid milium by electron microscopy. Am J Dermatopathol. 2009 Jul. 31(5):472-4. [Medline].

  19. Field LM. Re: the long pulsed Er:YAG laser and intravenous sedation versus dermabrasion (or laser) utilizing tumescent anesthesia for colloid milium. Dermatol Surg. 2002 Aug. 28(8):780. [Medline].

  20. Ammirati CT, Giancola JM, Hruza GJ. Adult-onset facial colloid milium successfully treated with the long-pulsed Er:YAG laser. Dermatol Surg. 2002 Mar. 28(3):215-9. [Medline].

  21. Zeng YP, Nguyen GH, Fang K, Jin HZ. A split-face treatment of adult colloid milium using a non-ablative, 1550-nm, erbium-glass fractional laser. J Eur Acad Dermatol Venereol. 2014 Dec 2. [Medline].

  22. Gomes J, Ventura F, da Luz Duarte M, Brito C. Colloid milium successfully treated with MAL-PDT. Int J Dermatol. 2013 Jun. 52(6):767-9. [Medline].

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Hematoxylin and eosin–stained section of skin (X40) showing a central focus of amorphous, eosinophilic, homogenous colloid with surrounding fissuring.
Elastic van Gieson stain of the same area showing strong (black) staining of the colloid for elastin.
 
 
 
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