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
more images of Milia at CETpoints . com
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