Colloid Milium Clinical Presentation

Updated: Jan 31, 2020
  • Author: Gorav Neel Wali, BMBCh, MA, MRCP; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Papules develop gradually over the facial area and light-exposed sites. Patients with colloid milium are usually asymptomatic, but they may have transient itching in affected areas.

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Physical Examination

The physical findings in colloid milium are usually limited to the skin.

Skin lesions of colloid milium

Amber, waxy, partially translucent, firm papules occur in crops, ranging from 1-5 mm in diameter. Gelatinous material can be expressed. In the nodular form, larger nodules (5-10 mm) or plaques develop. The underlying skin may be thickened, furrowed, and hyperpigmented. In the pigmented form, the papules are gray-black and confluent or clustered.

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. Nodules arising on one side of the face and the ipsilateral forearm have been described in a taxi cab driver. Upper eyelid margin involvement alone has been reported. [14] One case report describes nodular colloid milium affecting the conjunctiva and anterior orbit. [15] Juvenile colloid milium may be associated with ligneous conjunctivitis or ligneous periodontitis. [16] Rarely, lesions occur in the oral cavity. [17]

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