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Pediatric Milia Clinical Presentation

  • Author: Nicholas V Nguyen, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Apr 08, 2016
 

History

The clinical history varies somewhat between subtypes. Milia are usually asymptomatic.

Congenital milia are typically present at birth, although their onset may be delayed in premature neonates. Lesions usually resolve spontaneously.

Acquired milia have a tendency to persist without treatment. When acquired, a history of preceding trauma or associated bullous skin disease may be noted.

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Physical

The typical lesion is a 1-3 mm white to yellow, dome shaped and smooth papule. Lesions may be solitary or multiple.

Congenital milia predominate on the face, and the nose is commonly affected.

Benign acquired milia of children and adults favor the forehead, cheeks, eyelids, and genitalia.

Milia may be grouped.

Milia en plaque presents as an erythematous plaque studded with multiple milia. Lesions may be several centimeters in size.

Multiple eruptive milia favor the face, upper trunk, proximal extremities, and groin.

See the image below.

Milia in a week old infant. Milia in a week old infant.
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Contributor Information and Disclosures
Author

Nicholas V Nguyen, MD Resident Physician, Department of Dermatology, Children's Hospital Colorado, Denver Health Medical Center, University of Colorado Hospital, VA Eastern Colorado

Nicholas V Nguyen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, International Society of Dermatology, Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Tracy Funk, MD Fellow in Pediatric Dermatology, Department of Dermatology, The Children’s Hospital Colorado

Tracy Funk, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Academy of Pediatrics, Society for Pediatric Dermatology, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

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

Kevin P Connelly, DO Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University School of Medicine; Medical Director, Paws for Health Pet Visitation Program of the Richmond SPCA; Pediatric Emergency Physician, Emergency Consultants Inc, Chippenham Medical Center

Kevin P Connelly, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Osteopathic Pediatricians, American Osteopathic Association

Disclosure: Nothing to disclose.

Acknowledgements

Ruchir Agrawal, MD Chief, Allergy and Immunology, Aurora Sheboygan Clinic

Ruchir Agrawal, MD, is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American College of Allergy, Asthma and Immunology, and American Medical Association

Disclosure: Nothing to disclose.

References
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  2. Sachdeva M, Kaur S, Nagpal M, Dewan SP. Cutaneous lesions in new born. Indian J Dermatol Venereol Leprol. 2002 Nov-Dec. 68(6):334-7. [Medline].

  3. Langley RG, Walsh NM, Ross JB. Multiple eruptive milia: report of a case, review of the literature, and a classification. J Am Acad Dermatol. 1997 Aug. 37(2 Pt 2):353-6. [Medline].

  4. Southwick GJ, Schwartz RA. The basal cell nevus syndrome: disasters occurring among a series of 36 patients. Cancer. 1979 Dec. 44(6):2294-305. [Medline].

  5. Michaelsson G, Olsson E, Westermark P. The Rombo syndrome: a familial disorder with vermiculate atrophoderma, milia, hypotrichosis, trichoepitheliomas, basal cell carcinomas and peripheral vasodilation with cyanosis. Acta Derm Venereol. 1981. 61(6):497-503. [Medline].

  6. Rasmussen JE. A syndrome of trichoepitheliomas, milia, and cylindromas. Arch Dermatol. 1975 May. 111(5):610-4. [Medline].

  7. Su WP, Chun SI, Hammond DE, Gordon H. Pachyonychia congenita: a clinical study of 12 cases and review of the literature. Pediatr Dermatol. 1990 Mar. 7(1):33-8. [Medline].

  8. Bergman R, Schein-Goldshmid R, Hochberg Z, Ben-Izhak O, Sprecher E. The alopecias associated with vitamin D-dependent rickets type IIA and with hairless gene mutations: a comparative clinical, histologic, and immunohistochemical study. Arch Dermatol. 2005 Mar. 141(3):343-51. [Medline].

  9. Tsuji T, Kadoya A, Tanaka R, Kono T, Hamada T. Milia induced by corticosteroids. Arch Dermatol. 1986 Feb. 122(2):139-40. [Medline].

  10. Epstein W, Klingman AM. The pathogenesis of milia and benign tumors of the skin. J Invest Dermatol. 1956 Jan. 26(1):1-11. [Medline].

  11. Honda Y, Egawa K, Baba Y, Ono T. Sweat duct milia--immunohistological analysis of structure and three-dimensional reconstruction. Arch Dermatol Res. 1996 Mar. 288(3):133-9. [Medline].

  12. Weedon D. Cutaneous infiltrates—non-lymphoid. Weedon D, ed. Weedon’s skin pathology. New York: Churchill Livingstone; 2010.

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Milia in a week old infant.
 
 
 
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