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Benign Melanocytic Lesions
Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Natalia Jaimes, Ashfaq A. Marghoob
Milia-like cysts (Figures 7a.19 and 7a.20) are white to yellow, rounded, often hazy structures that correlate histologically with intraepidermal keratin cysts/pseudocysts (17). They derive their name from their resemblance to the small seeds or millets of various grain grasses. They may be observed scattered throughout a CMN (6). It is important to stress that although the presence of milia-like cysts is one of the dermoscopic hallmarks of seborrheic keratosis, they can also be seen in melanocytic neoplasms, including CMN, papillomatous dermal nevi, and rarely, melanomas (2, 3). Thus, if the lesion is deemed to be a nonmelanocytic growth, then the presence of multiple milia-like cysts favors the diagnosis of seborrheic keratosis; however, if the lesion is a melanocytic tumor, then the presence of multiple milia-like cysts favors a diagnosis of CMN. With that being said, it is important to remember that in a melanocytic tumor, the presence of milia-like cysts, in and of themselves, is not diagnostic of a CMN, since they can also be seen in melanoma.
Benign Neoplasms
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Abdullah Demirbaş, Ömer Faruk Elmas, Necmettin Akdeniz
Overview: Milia can be congenital or acquired and are common in all age groups. The congenital type can be seen as many small papules around the nose, which can regress spontaneously in 3–4 weeks. Diseases, such as Maria-Unna hypotrichosis and oral-facial-digital syndrome, should be considered for congenital types that are more generalized and do not disappear spontaneously. Acquired milia can also occur secondary to diseases that cause subepidermal bulla formation, such as epidermolysis bullosa, porphyria cutanea tarda, and bullous pemphigoid.
Tissue Grafting Techniques
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
In the first 6 months, milia-like cysts can occur at the recipient site, especially on the face and neck. Many authors believe that milia develop due to remnants of epithelial cells following the dermabrasion, but a more plausible explanation for their development is occlusion of the sweat ducts where the outflow is blocked, in collaboration with rapid proliferation of the epithelial cells at the ends of the ducts [13]. A uniform dermabrasion and thorough cleansing of the dermabraded site before applying the graft can reduce this complication. Once developed, these can be managed easily by puncturing them with a fine needle and expressing out the contents. However, the authors have rarely encountered milia in clinical practice.
Management of resistant halo nevi
Published in Journal of Cosmetic and Laser Therapy, 2019
Sherif S Awad, Rasha TA Abdel Aziz, Sahar S Mohammed
Pigmentation of the graft was observed 2 weeks after the procedure. Depression at the site of the removed nevus was observed underneath the graft at the first month but disappeared completely afterward. Five cases started losing the pigment after 3 weeks, but with the maintenance of the NB-UVB sessions, complete repigmentation was achieved after the 3-month period. Milia were seen in five patients and were treated by simple evacuation with very good cosmetic outcome. In only one case, peri-graft halo persisted. No scarring developed in all cases either in the recipient or in the donor area. Further follow-up did not show any re-depigmentation in all cases, and satisfactory results could be traced up to 2 years postoperatively in some of the cases (Figures 2 and 3).
Milia within resolving bullous pemphigoid lesions
Published in Baylor University Medical Center Proceedings, 2019
Sima Amin, Connie T. Fiore, So Yeon Paek
The patient had a difficult and prolonged hospital course. Despite stopping the presumed causative agent, furosemide, and starting high doses of prednisone (1 mg/kg) along with mycophenolate mofetil, the patient continued to develop new, large bullae. Due to the recalcitrant nature of his condition, the patient was given a 4-day course of intravenous immunoglobulin (2 g/kg), and dapsone was started. Over the next 8 weeks, while remaining on mycophenolate mofetil, dapsone, and prednisone taper, the patient’s condition stabilized. However, he began to note crops of asymptomatic pinpoint white papules within his resolving bullae (Figure 2a). A 4-mm punch biopsy specimen was obtained for histopathologic examination of a representative lesion on the left upper arm. Histologic examination of the specimen from the left upper arm showed a dermal unilocular cyst lined by stratified squamous epithelium with a granular cell layer (Figure 2b). The cyst contents included basket-woven keratin debris. The clinicopathologic findings were suggestive of milia arising within resolving BP lesions.
Complications and posttreatment care following invasive laser skin resurfacing: A review
Published in Journal of Cosmetic and Laser Therapy, 2018
Dan Li, Shi-Bin Lin, Biao Cheng
Typically, an open dressing refers to the direct application of an ointment or cream alone to the wound. Although inexpensive, convenient and easy for home care, this method may increase the risk of acne, milia and infection(50). Aquaphor is the most common ointment used for open dressings after LSR. Sarnoff compared the effects of the application of Aquaphor Healing Ointment (AHO) and Biafine Topical Emulsion (BTE) after fractional LSR. Twenty subjects were included in his double-blind, split-face study, and erythema, edema, epithelial confluence, and crusting/scabbing were assessed on days 2, 4, 7, and 14. The results showed that AHO was more effective in promoting wound healing than BTE(51). Tanzi et al. compared the effectiveness of a mucopolysaccharide-cartilage complex (MCC) healing ointment with that of Aquaphor. Their study showed that the MCC ointment, as a posttreatment care medication, was more effective than Aquaphor in reducing erythema, edema and erosion(52).