Milia

Milia is a topic covered in the Select 5-Minute Pediatrics Topics.

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Basics

Description

  • Common benign, keratin-filled cysts that present as white pinpoint papules most typically on the face but may occur elsewhere on the body (palate, gingiva, penis)
  • Subtypes include primary and secondary milia.
    • Primary: spontaneous
    • Secondary: secondary to trauma, medications, or another disease
  • Milia en plaque—rare type of primary milia which typically occurs in the posterior auricular area as an erythematous plaque

Epidemiology

  • Congenital milia is the most common form of primary milia.
    • Approx. 40% of newborns have milia.
    • Less common in premature infants
    • No gender or racial predilection
  • Secondary milia can occur in all age groups.

Risk Factors

  • Full-term newborns
  • Any bullous condition increases the risk of secondary milia, particularly epidermolysis bullosa and porphyria.

Genetics

  • No known genetic predisposition for primary congenital milia, the most common type of milia encountered in pediatrics
  • Milia may be a major feature of rare genetic diseases of the skin (Loeys-Dietz syndrome, oral-facial-digital syndrome type 1, Rombo syndrome, or Bazex-Dupré-Christol syndrome).

General Prevention

There are no known preventative measures for primary milia.

Pathophysiology

  • Retention of keratin and sebaceous material within the pilosebaceous duct, eccrine sweat duct, or sebaceous collar surrounding fine vellus hair

Etiology

  • Most commonly spontaneous in newborns
  • May be related to trauma or blistering conditions in older children

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