Milia
Milia are very small( 1-2mm), sub-epidermal keratincontaining cysts, seen as superficial small pearly-white elevations on the skin. They mainly arise from undeveloped sebaceous glands, and sometimes from sweat glands. Milia are very common in new-borns, affecting approximately 50 % of babies. 19 In babies milia tend to resolve over a short period of time but in adults they can persist for years. In adults milia occur in isolation and are usually surrounded by normal skin. Occasionally they occur in a cluster or plaque as a result of secondary skin damage. Spontaneous disappearance occurs in the majority of cases.
Figure 7 Seborrhoeic Keratoses vary in colour from light to dark brown
local anaesthetic. Such treatments are often deemed cosmetic and may not be funded by the local NHS service. Aesthetic and dermatology clinics usually offer private removal services.
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Management Milia are very common in adolescents and adults and are usually seen on the cheeks, the eyelids and the nose. They are not contagious and, unless cosmetically unacceptable for the patient, treatment is not necessary. 20 If treatment is required the surface of milia can be opened with a sterile needle or a fine surgical blade and the contents squeezed out. The careful use of cryotherapy or diathermy can also be effective.
See
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Lentigo
A lentigo( plural lentigines) is a pigmented flat or slightly raised lesion with a clearly defined edge. Unlike a freckle, a lentigo maintains its pigmentation throughout the year. Lentigines affect men and women of all ages and races but are especially common in fair-skinned adults. They are associated with exposure to UV radiation. 16 Widespread lentigines present at birth or arising in early childhood are associated with various systemic syndromes. 17
Lentigines may be solitary but are more often multiple. Most are less than 5 mm in diameter. They are categorised into different appearances according to their underlying cause. 18
Management
Most lentigines require no treatment. But they can be confused with melanoma. Patients with suspected melanoma should be referred to their GP for further investigation.
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Figure 8 A large solar Lentigo on the face
Figure 9 Milia are common on the soft skin of the eyelids
Benign Melanocytic Naevus( Mole)
A mole is a common benign skin lesion caused by a local proliferation of pigment cells( melanocytes). It is more correctly called a melanocytic naevus. 21 Almost everyone has some moles, and nearly all of them are harmless. A normal mole is usually an evenly-coloured brown, tan, or black spot on the skin. It can be either flat or raised, round or oval. They range in size from a couple of millimetres to several centimetres in diameter. 22
Moles may arise on any part of the body. They differ in appearance depending on the body site and may be flat or protruding. They vary in colour from pink or flesh tones to dark brown, steel blue, or black. Their colour is usually consistent across the entire mole. Although mostly round or oval, moles are sometimes unusually shaped. Moles that are larger, have an abnormal shape or have more than one colour are more likely to become a melanoma. 23 People with a greater number of moles have a higher risk of developing melanoma especially if they have over 100 of them.
Management
Normal moles can sometimes change appearance, for example following sun exposure or during pregnancy. They can enlarge, regress or involute( disappear). 24 However, moles that change is size our colour should be referred to rule out melanoma.
People often worry about moles because they can look
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April 2017 | etCETera 15