ABSTRACT
Resumen El milium coloide (MC) es un trastorno de depósito cutáneo poco común, asociado a cambios degenerativos secundarios a la radiación ultravioleta, que provoca degeneración de las fibras elásticas en la dermis. Tiene dos formas de presentación definidas como juvenil y del adulto. Es más común en hombres que realizan oficios al aire libre. Clínicamente se caracteriza por numerosas y pequeñas pápulas de distintos colores (amarillo, ámbar, café) o translúcidas, que suelen agruparse y se localizan en zonas fotoexpuestas. El diagnóstico se confirma mediante el estudio histopatológico y pudiera requerir tinciones especiales para diferenciar la mucina y el amiloide. Para su tratamiento se han empleado técnicas como dermoabrasión mecánica, láseres, terapia fotodinámica, entre otros.
Abstract Colloid milium is a rare skin deposition disorder associated with degenerative changes secondary to ultraviolet radiation, which causes degeneration of elastic fibers in the dermis. It has two forms of presentation defined as juvenile and adult. It is more common in men who work outdoors. Clinically it is characterized by numerous small yellow, brown, amber or translucent papules that are usually grouped together, located over photo-exposed areas. The diagnosis is confirmed by histopathological study and may require special stains to differentiate mucin and amyloid. Techniques such as mechanical dermabrasion, lasers, photodynamic therapy, among others, have been used for its treatment.
ABSTRACT
Colloid degeneration of the skin is a rare, distinct clinicopathological entity characterized by the deposition of colloid material in the dermis. Nodular colloid degeneration (NCD) is a clinical variant of colloid degeneration of the skin. Herein, we report the case of a 40-year-old woman who presented with a 3-year history of multiple asymptomatic yellowish-brown, indurated papules and plaques on her forehead. Histopathologic examination of the lesion revealed deposition of amorphous pale pink homogenous colloid material with irregular clefts, fissures, and scattered pyknotic nuclei in the upper dermis. The material was negative for Congo red staining, and periodic acid-Schiff and Masson's trichrome staining revealed positive reactivity. Scattered fragmented elastic fibers were present in the colloid material on Verhoeff—Van Gieson staining. The patient was diagnosed with NCD. We propose that NCD should be considered in the differential diagnosis of long-standing facial nodules and plaques.
Subject(s)
Adult , Female , Humans , Colloids , Congo Red , Dermis , Diagnosis, Differential , Elastic Tissue , Forehead , SkinABSTRACT
@#A 65-year-old female with chronic kidney disease (CKD) presented with a six-month history of asymptomatic translucent skin-colored and yellow plaques on the face. Similar yellow papules and nodules were noted in the oral cavity and eyelid margins. Biopsies were taken from the face and oral cavity showed homogeneous eosinophilic deposits with clefts in the dermis consistent with colloid milium. The patient was treated with fractional and surgical carbon dioxide (CO2) laser with improvement after one session.
Subject(s)
Renal Insufficiency, Chronic , Carbon DioxideABSTRACT
Syringoma is the most common type of benign intraepidermal eccrine sweat gland tumor in Korea, and is usually found in women in their forties. It presents mostly as a localized lesion, preferring the lower eyelid, cheek, or forehead, and rarely invades the vulval area, and in the case of children, vulvar invasion is even more rare. Tranilast is an antihistamine used for atopic dermatitis and asthma, and has recently been used for the treatment of keloid. A few previous studies have reported both localized and generalized forms of syringoma being effectively resolved with tranilast. Herein, we report a rare and interesting case of milium-like syringoma, which manifested on the vulval area of 10-year old girl that was successfully treated with tranilast.
Subject(s)
Child , Female , Humans , Asthma , Cheek , Dermatitis, Atopic , Eyelids , Forehead , Keloid , Korea , Sweat Glands , Syringoma , VulvaABSTRACT
Scrotal calcinosis is a relatively common tumor of the male genitalia but there is controversy in the literature regarding its pathogenesis. The authors of many case reports debate whether the lesions are truly idiopathic or if they arise from other conditions. Only few cases of scrotal calcinosis have been proven to have an eccrine origin so far. Herein, we report a case of scrotal calcinosis originating from a milium-like syringoma in a male Korean patient.
Subject(s)
Humans , Male , Calcinosis , Genitalia, Male , Scrotum , SyringomaABSTRACT
Lupus miliaris disseminatus faciei (LMDF) is a chronic inflammatory disorder primarily affecting the face. A 22-year-old man presented with facial skin lesions. Physical examination revealed scattered pin-head sized erythematous to yellowish papules. Skin biopsy from the erythematous papule showed keratinous material in the layers of the thin epithelium and caseous necrosis with adjacent epitheloid granuloma and giant cells. After mechanical extractions of milium-like inflamed papules, skin lesions improved leaving an atrophic scar. LMDF was initially thought to be associated with tuberculosis infection but today it is considered a variant of rosacea. However, there have been reports of LMDF in association with epidermal cysts or milium, suggesting an abnormal immune response to the pilosebaceous unit may play a role. Damage to the pilosebaceous unit that is further complicated by milium rupture may induce inflammation resulting in LMDF. We suggest that milium or epidermal cysts may also attribute to the pathogenesis of LMDF although further studies are needed.
Subject(s)
Humans , Young Adult , Biopsy , Cicatrix , Epidermal Cyst , Epithelium , Giant Cells , Granuloma , Inflammation , Necrosis , Physical Examination , Rosacea , Rupture , Skin , TuberculosisABSTRACT
Los quistes de milium son pápulas minúsculas, color blanco-amarillentas, que histológicamente consisten en pequeños quistes revestidos por un epitelio plano estratificado con queratina lamelar ortoqueratótica en su interior. Cuando se presentan de manera súbita y con un número y extensión mayores de lo esperado, se denominan quistes de milium eruptivos. Estos afectan con más frecuencia a adolescentes y adultos jóvenes, y se ubican principalmente en la cara y el tronco. Presentamos el caso de un paciente de sexo masculino, de 11 años de edad, sin antecedentes de importancia, que consulta por quistes de milium eruptivos, de un año de evolución, localizados en ambos párpados inferiores.
Eruptive milia are tinny white or yellowish papules that histologically correspond to cysts lined by a thin stratified squamous epithelium containing orthokeratotic-laminated keratin. When they appear suddenly and in number and extension greater than expected they are named eruptive milia. They predominantly affect teenagers and young adults and are located mainly in the face and the trunk. We report an 11 years old male patient without a relevant personal history, who complained of eruptive milia, of one year of evolution, located on both lower eyelids.
Subject(s)
Humans , Male , Child , Epidermal Cyst , Miliaria , CystsABSTRACT
Milia are small, superficial keratin cysts believed to be derived from the pilosebaceous follicle, which arise most commonly on the cheeks and eyelids. We report a case of milium occurring on the glans penis in a 18-year-old man, who had a solitary dome-shaped, 2x2 mm sized, yellowish papule. The histopathological examination showed a small keratin-filled, intradermal cyst. The cyst was lined by a stratified epithelium that was a few cell layers thick. This is the first case report in the Korean dermatological literature of milium occurring on the glans penis without coexistence of other dermatoses.
Subject(s)
Adolescent , Humans , Male , Cheek , Epithelium , Eyelids , Keratins , Penis , Skin DiseasesABSTRACT
Milium is an asymptomatic, tiny, subepidermal, keratinous cyst found primarily on the cheek and eyelids. Milium is thought to result from pilosebaceous or eccrine duct plugging. Secondary milium develop when other underlying factors are present such as bullous diseases, various inflammatory skin diseases, and trauma. We report an 8-year-old boy who had a solitary, dome-shaped, whitish papule with 2x3 mm gray macule at the site, pricked by pencil. Histopathologically, the lesion showed the typical findings of milium and foreign body reaction caused by graphite. We treated this using punch excision and there has been no evidence of recurrence for 7 months.
Subject(s)
Child , Humans , Cheek , Eyelids , Foreign-Body Reaction , Graphite , Keratins , Recurrence , Skin DiseasesABSTRACT
We report here on a 71-year-old female who had well-demarcated erythematous patches, along with some pearly papules, on the right cheek. Histopathological examination of the lesions revealed a basaloid cell mass, which appeared to be a superficial basal cell carcinoma, and a small keratin-filled cyst that appeared to be a milium. A part of the milium was surrounded by the basaloid cells of tumor islands and milia later developed on the lesion of basal cell carcinoma. We suggest that basal cell carcinoma may be one of the causes of secondary milia.
Subject(s)
Aged , Female , Humans , Carcinoma, Basal Cell , Cheek , IslandsABSTRACT
Milium-like syringoma is a rare variant of syringoma first described by Friedman and Butler in 1987. Clinically, it presents as milium, but histologically reveals syringoma with overlying keratin filled epidermoid cysts. It occurs predominantly on the periorbital area of middle-aged women. Syringomas on the genital area have rarely been reported. The lower portion of the cysts and keratin materials show positivity for CEA and negativity for CK7. The pathogenesis is not well defined, but there are some hypotheses, which include pruritus and increasing hormonal receptors (estrogen and progesterone receptors). We report a case of milium-like syringoma on the vulva.
Subject(s)
Female , Humans , Epidermal Cyst , Keratins , Progesterone , Pruritus , Syringoma , VulvaABSTRACT
Milium-like syringoma is a rare clinical variant of syringoma, characterized by 1~2 mm, yellowish-white, domed papules. Milium-like syringoma can be clinically mistaken for milia because the lesions are usually similar in appearance. Histopathological examination showed keratin-filled cysts in the papillary dermis and numerous tadpole-shaped epithelial strands in the upper half of the dermis below the cyst. Moreover, most cases report the direct connection between the epithelial strands and the wall of the keratin-filled cyst. We report a rare case of milium-like syringoma in an 8-year-old girl.
Subject(s)
Child , Humans , Dermis , SyringomaABSTRACT
A healthy 4-year-old boy presented with a linear erythematous eruption, along with some pearly papules on the right cheek. The distribution of the lesions corresponded to that of Blaschko?s lines. Histopathological examination showed necrotic keratinocytes and vacuolar changes on the basal layer in the epidermis, and a superficial and deep perivascular, perieccrine, and perifollicular lymphocytic infiltrate in the dermis. In addition, a small keratin-filled cyst was observed in the upper dermis. These findings were consistent with a diagnosis of milium developing on lichen striatus. We applied 0.03% topical tacrolimus ointment twice daily. On follow-up 12 months later, the linear erythematous eruption cleared, but the pearly papules persisted.
Subject(s)
Child, Preschool , Humans , Male , Cheek , Dermis , Diagnosis , Epidermis , Follow-Up Studies , Keratinocytes , Lichens , TacrolimusABSTRACT
We report a 48-year-old female who had eruptive vellus hair cysts associated with milia on the face. Histopathologic examination of lesions on the forehead and cheek showed typical findings of eruptive vellus hair cysts and milia. These findings suggested that two entities are in some way related. Eruptive vellus hair cysts and milia can be considered as subtypes of multiple pilosebaceous cysts that may all present overlapping histologic features.
Subject(s)
Female , Humans , Middle Aged , Cheek , Forehead , HairABSTRACT
Ultrastructural study was taken in a 48 year old male farmer with colloid milium. Electrcn microscopically, colloid was mainly composed of protofilaments, amorphous substance and degenerating collagens surrounded by halos. Colloidal filaments were curved and branched at their ends. Fibroblasts near the colloid island contained amorphous materials and protofilaments idnitical to that of colloid materials, Thus we suggest that. colloid milium may be produced by the abnormal fibroblasts or may be derived from actiinically damaged collagen fibers.