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Milia in Child
See also in: External and Internal Eye
Other Resources UpToDate PubMed

Milia in Child

See also in: External and Internal Eye
Contributors: Lowell A. Goldsmith MD, MPH, Craig N. Burkhart MD, Dean Morrell MD
Other Resources UpToDate PubMed

Synopsis

Milia (singular, milium) are minute epidermoid cysts (also known as infundibular cysts) that present as small white or yellow papules, usually on the face of infants and adults although they can also occur in children. They are typically smaller than 3 mm in diameter. Primary milia affect 40%-50% of newborns but may be found in patients of all ages. Secondary milia often occur after injury to the skin, such as from burns or subepidermal blistering disorders (epidermolysis bullosa). Milia have also been known to occur in areas of topical steroid-induced atrophy. Persistent or widespread milia are associated with a number of syndromes. There is no predilection for either sex or for any race or ethnicity.

Codes

ICD10CM:
L72.8 – Other follicular cysts of the skin and subcutaneous tissue

SNOMEDCT:
254679001 – Milia

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Milia are sometimes confused with closed comedones of Acne vulgaris.
  • Pustular acne (see Acne vulgaris)
  • Closed comedones (see Acne vulgaris)
  • Cosmetic-induced acne
  • Molluscum contagiosum
  • Sebaceous hyperplasia
  • Trichoepithelioma
  • Keratosis pilaris
  • Milia-like Calcinosis cutis
  • Osteoma cutis
  • Syringoma
  • Eruptive vellus hair cyst
  • Nevus comedonicus
Some syndromes associated with milia are as follows:
  • Congenital hypotrichosis
  • Atrichia congenita is a genetic condition of alopecia with milia; patients may be born with hair, but it falls out and is not replaced.
  • Rombo syndrome
  • Follicular atrophoderma and basal cell epitheliomata
  • Pachyonychia congenita
  • Oral-facial-digital syndrome (type 1) has multiple milia in the first few years of life in addition to congenital mouth and digital malformations.
Blistering disorders that may heal with milia and scarring are as follows:
  • Epidermolysis bullosa acquisita
  • Porphyrias, including Porphyria cutanea tarda
  • Bullous pemphigoid of childhood
  • Herpes zoster
  • Allergic contact dermatitis
  • Bullous systemic lupus erythematosus
  • Dermatitis herpetiformis

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:01/24/2021
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Milia in Child
See also in: External and Internal Eye
A medical illustration showing key findings of Milia (Pediatric) : Cheek, Eyelids, Face, Nose, White color, Tiny papules
Clinical image of Milia - imageId=59031. Click to open in gallery.  caption: 'Few tiny, smooth, white papules near the eye.'
Few tiny, smooth, white papules near the eye.
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