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