Milium coloide: reporte de un caso y revisión de la literatura / Colloid milium: a case report and review of the literature

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.

Mass Forming Basement Membrane Material Secondary to Adnexal Adenocarcinoma - a Case Report.

We report a 77-year-old male with biopsy proven adnexal adenocarcinoma where there was only mass deposit of basement membrane material in the therapeutic excision. To our knowledge, this finding is extremely rare and has not been previously described in the literature and necessitates distinction from other conditions which cause eosinophilic hyaline deposits within the dermis.

Eruptive milia and acneiform hyperkeratosis with comedones (pseudo-epidermal cysts) within tattoos.

BACKGROUND: Milia are small, hard, white superficial epidermal cysts measuring a few millimetres that can occur during skin healing due to occlusion of pilosebaceous units. Milia rarely occur on tattoos. However, cases of allergic reactions with hyperkeratosis and open comedones have been described in the literature, sometimes under the term "epidermal cysts". PATIENTS AND METHODS: We saw three patients who developed milia, including a 32-year-old man with eruptive milia 10 weeks after getting a black, red and green tattoo on his upper arm. Topical tretinoin was applied. We encountered two further cases of eruptive milia on black/grey tattoos. A fourth patient presented a massive hyperkeratotic reaction with retention comedones on the red/pink area of a tattoo. DISCUSSION: The occurrence of milia and acneiform allergic reactions after tattooing is rare. We collated a total of 13 cases from the literature, of which 8 involved milia. This condition occurred within 3 months following tattooing, with no particular correlation with any given colour, and generally without any allergic reaction (except in one case). Reactions comprising excessive acneiform hyperkeratosis and open comedones were noted with pink and red inks and were a complication in a setting of allergic inflammatory reaction. However, the histopathology of these reactions is poorly described in the literature. It seems inappropriate to diagnose the condition as "epidermal cysts" since the lesions are not in fact simple cysts but rather retention lesions occurring during an inflammatory reaction and are thus different from post-traumatic milia.

Milia within resolving bullous pemphigoid lesions.

Bullous pemphigoid (BP) is a blistering dermatosis characterized by an autoimmune response to two hemidesmosomal proteins, BP180 and BP230. We describe a case of an 80-year-old man diagnosed with BP by clinical features, histopathology, and immunosorbent assay who developed milia within resolving BP lesions. Milia formation during recovery is common in cases of mucous membrane pemphigoid and epidermolysis bullosa acquisita but has rarely been reported in cases of BP.

A case of Mucocutaneous Colloid Milium in an adult Filipino female with chronic kidney disease

@#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.

A Case of Nodular Colloid Degeneration in a 40-year-old Woman / 대한피부과학회지

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.

Biotic and abiotic drivers of intraspecific trait variation within plant populations of three herbaceous plant species along a latitudinal gradient.

BACKGROUND: The importance of intraspecific trait variation (ITV) is increasingly acknowledged among plant ecologists. However, our understanding of what drives ITV between individual plants (ITVBI) at the population level is still limited. Contrasting theoretical hypotheses state that ITVBI can be either suppressed (stress-reduced plasticity hypothesis) or enhanced (stress-induced variability hypothesis) under high abiotic stress. Similarly, other hypotheses predict either suppressed (niche packing hypothesis) or enhanced ITVBI (individual variation hypothesis) under high niche packing in species rich communities. In this study we assess the relative effects of both abiotic and biotic niche effects on ITVBI of four functional traits (leaf area, specific leaf area, plant height and seed mass), for three herbaceous plant species across a 2300 km long gradient in Europe. The study species were the slow colonizing Anemone nemorosa, a species with intermediate colonization rates, Milium effusum, and the fast colonizing, non-native Impatiens glandulifera. RESULTS: Climatic stress consistently increased ITVBI across species and traits. Soil nutrient stress, on the other hand, reduced ITVBI for A. nemorosa and I. glandulifera, but had a reversed effect for M. effusum. We furthermore observed a reversed effect of high niche packing on ITVBI for the fast colonizing non-native I. glandulifera (increased ITVBI), as compared to the slow colonizing native A. nemorosa and M. effusum (reduced ITVBI). Additionally, ITVBI in the fast colonizing species tended to be highest for the vegetative traits plant height and leaf area, but lowest for the measured generative trait seed mass. CONCLUSIONS: This study shows that stress can both reduce and increase ITVBI, seemingly supporting both the stress-reduced plasticity and stress-induced variability hypotheses. Similarly, niche packing effects on ITVBI supported both the niche packing hypothesis and the individual variation hypothesis. These results clearly illustrates the importance of simultaneously evaluating both abiotic and biotic factors on ITVBI. This study adds to the growing realization that within-population trait variation should not be ignored and can provide valuable ecological insights.

Nodular colloid milium mimicking keloid.

Colloid milium is a rare cutaneous deposit disease that usually presents clinically by the development of yellowish translucent or flesh-colored papules or plaques on sun-exposed skin. Histologically, it is characterized by the presence of colloid in the dermal papillae. In this case report, we present a 52-year-old man who presented with a nodule on his upper lip that mistakenly was diagnosed and treated as keloid.

[Eruptive epidermoid cysts during topical imiquimod treatment]. / Éruption de kystes épidermiques après application d'imiquimod topique.

BACKGROUND: Imiquimod is a local immune-response modifier that works by stimulating innate and acquired immunity. It is frequently used to treat superficial basal cell carcinoma, the most common form of skin cancer. Marked local inflammatory reaction is common during treatment. We report a case of the rare condition, multiple eruptive milia, during topical imiquimod therapy. PATIENTS AND METHODS: A 67-year-old male patient presented infiltrating basal cell carcinoma above the left eyebrow. The patient underwent surgery and skin grafting. He presented superficial relapse at the periphery of the graft and was initially treated with Aldara®. Fifteen days after initiation, Aldara® was withdrawn due to a critical inflammatory reaction. A few weeks after complete healing, an erythematous annular plaque of milia, excluding the graft zone, appeared. This element was confirmed by histopathology. DISCUSSION: The most common local side effects reported with Aldara® are erythema, irritation and crusting. Reports of eruptive milia following Aldara® therapy are rare and they are never mentioned in the summary of product characteristics. Application of imiquimod in fact induces local inflammatory reaction due to stimulation of local cytokines, which can result in marked reaction in the infundibular epithelium of hair follicles and thus in the production of abnormal keratin that can cause pilosebaceous duct obstruction and thus the formation of epidermoid cysts. This pathological mechanism explains the absence of lesions on the skin graft of the inner arm. CONCLUSION: The occurrence of eruptive milia during treatment with Aldara® is rarely described. The timing of occurrence of these eruptive milia as well as the mechanism of action of the drug made such a reaction highly probable in our patient.

Primary Milium of the Nipple / 대한피부과학회지

No abstract available.

A Case of Vulvar Milium-like Syringoma in a Child Treated with Tranilast / 대한피부과학회지

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.

[The colloid milium: An observation associated with trichinosis]. / Milium colloïde : une observation associée à une trichinose.

The colloid milium has four clinical forms: adult colloid milium, juvenile colloid milium, paracolloid (or nodular colloid degeneration) and pigmented colloid milium. We report the case of an adult colloid milium in a man of 56, who presented episodes of diffuse pruritus associated with myalgia and digestive disorders, indicative of trichinosis. He also developed gradually over the past 10 years, yellowish injuries in the mandibles and neck for whom histology objectified a colloid milium. Etiology and treatment are still unknown; association with a trichinosis is probably coincidental.

Multiple milia formation induced by dovitinib.

Dovitinib is a novel multi-target tyrosine kinase inhibitor that inhibits vascular endothelial growth factor receptor-1-3, platelet-derived growth factor receptor-ß, Fms-like tyrosine kinase 3, c-Kit and fibroblast growth factor receptor-1-3. This compound is currently being assessed clinically for treatment of various malignancies. In phase I and II clinical trials of dovitinib treatment for renal cell carcinoma, 20% of patients experienced cutaneous adverse events, although the specific type of skin rash was not documented. Here, we report two cases of multiple milia formation induced by dovitinib. We believe our cases are the first report mainly showing non-inflammatory cystic structure.

A Case of Adult Colloid Milium on the Scalp / 대한피부과학회지

No abstract available.

A Case of Scrotal Calcinosis Originating from a Milium-like Syringoma / 대한피부과학회지

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.

Nodular colloid degeneration of the skin: Report of three cases with review and update.

Nodular colloid degeneration (NCD) is a rare dermatological disorder and uncommon type of colloid milium. The degeneration may be related to sun exposure. In this report, three cases, all presenting as multiple plaques and nodules over the nose and the face are depicted. Histologically, these nodular masses were homogeneous, with eosinophilic-cleaved materials expanding the papillary dermis and extending into the deep dermis. Periodic acid Schiff (PAS), crystal violet, and methyl-violet stains highlight the colloid material. All the three cases were finally diagnosed as NCD. NCD could be considered in any case with facial nodules and a long history of sun exposure. We suggest the long-term sun exposure as an etiologic factor; thus sun protection would be the most preventive and available treatment.

Refractory bullous pemphigoid leaving numerous milia during recovery.

Recovery with milia may occur in bullous pemphigoid (BP), mucous membrane pemphigoid (MMP) and epidermolysis bullosa acquisita (EBA). Scarring commonly occurs in MMP and EBA. Here, we report a 62-year-old man patient with BP, who was left with numerous milia during recovery. The patient had immunoglobulin (Ig)G autoantibodies to the recombinant protein of the BP180-NC16a domain and the soluble 120-kDa ectodomain of BP180 (linear IgA bullous dermatosis [LAD]-1). There are cases of BP with IgG autoantibodies to LAD-1 and/or the recombinant protein of BP180 C-terminal domain. Extensive milia formation during recovery may be associated with immunological predisposition and/or improper interaction between hemidesmosomes and the extracellular matrix components.

Infrared-induced adult colloid milium treated with fractionated CO2 laser.

Adult colloid milium is a rare cutaneous deposition disorder that frequently involves areas of chronic sun exposure. The most common clinical presentation exhibits multiple, firm, and amber-colored papules that cluster to form large plaques. Histologically, there are masses of amorphous, eosinophilic material expanding the papillary dermis, and at times extending into the mid-dermis, with adjacent solar elastosis. When this disorder affects the face, disfiguring is of great concern and treatment is often sought. Attempts to safely remove colloid milium are generally unsuccessful. Dermabrasion has been reported to be effective. The present authors present a case with extensive facial colloid milium successfully ablated by the fractionated CO2 laser.