At a glance: Syringoma versus milia Syringoma

Clinical features

  • First appear at puberty; additional lesions can develop later.
  • Skin-coloured or yellowish, small, asymptomatic dermal papules that may appear translucent or cystic.
  • Less than 3mm in diameter.
  • Multiple in symmetrical clusters.
  • Commonly seen on upper cheeks and lower eyelids.
  • Eruptive syringomas appear as multiple lesions on the chest or lower abdomen.
  • Common in Asian or dark-skinned patients.

Management

  • Excision, electrodessication and curettage, dermabrasion or resurfacing with a CO2 laser.
  • Can recur.

Milia
Clinical features

  • Asymptomatic, keratin-filled cysts.
  • Equal prevalence for primary and secondary milia.
  • Superficial, pearly white, 1–2mm in diameter.
  • Primary milia in newborns are common and occur on the face, nose and palate.
  • Primary milia in older children and adults develop on the face around the eyes.
  • Secondary milia are observed in some blistering disorders and following dermabrasion.  

Management

  • Incision or cautery if patients request it.

Contributed by Dr Vasa Gnanapragasam, a GP in Sutton, Surrey

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