Milia

≠ Miliaria!
 
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Milia
Miliaria
Clinical presentation
Pápulas brancas/peroladas, firmes, 1-2mm
Crystalina - vesículas translúcidas
Rubra - pápulas eritematosas pruriginosas
Profunda - pápulas cor de pele
Mechanism
Retenção de queratina de origem folicular
Obstrução dos ductos écrinos
- crystallina no stratum corneum
- rubra no stratum spinosum
- profunda na profundidade
Etiology
Hormonal
Secondary (scars, burns, porphyria, epidermolysis bullosa)
overheating, over-swaddling, fever
 
Clinical presentation
  • Small, pinhead sized, white, very superficial bumps on the skin that can be easily removed with a vaccinostyle or a beveled needle
  • In newborns
    • Tiny wite spots on the face
    • Disappear spontaneously within a few weeks and are caused by temporary sebaceous retention due to hormonal factors
  • In adolescents and adults
    • Isolated or numerous milia are commonly observed on the cheeks, eyelids and nose
    • They form due to blockage of the pilary canal of lanuginoid follicles or epidermoid metaplasia of their strucutres
    • Contain compact keratin and are more common in women
  • Secondary milium
    • Appears on scars, burns and especially in certain bullous dermatoses (particularly porphyria and congenital epidermolysis bullosa)
    • Here, the grains form due to post-lesional obstruction of a follicule, but also, if not primarily, due to retiention and then epidermoid metaplasia of the excretory sweat ducts interrupted by the scarring or bullous process (eccrine millium)
 
Tratamento
  • Furar com agulha e drenar com pinça