A case of mucocutaneous colloid milium in an adult Filipino female with chronic kidney disease

Authors: Shahara Abalos, MD, Eileen Liesl A. Cubillan, MD, FPDS

Abstract

Introduction: Colloid milium is a rare disorder characterized by appearance of skin-colored to yellow papules mostly in sun-exposed skin. The exact pathogenesis of this disease is not yet known but ultraviolet exposure has been implicated. There have been reports of concurrence with beta thalassemia, vitamin C deficiency and trichinosis however no disease association has been definitely established.

Case Summary: We report the first case of a 65 year old female with chronic kidney disease (CKD) presenting with six month history of asymptomatic multiple, firm, translucent skincolored to yellow papules and plaques distributed over the periorificial areas. Similar concurrent lesions were also noted on the oral cavity and bilateral eyelid margins. Histopathologic examination of lesions from the periorbital area, lower labial mucosa and tongue showed homogeneous eosinophilic fissured deposits in the papillary dermis consistent with colloid milium. Histochemical stains of the deposits with Periodic-Acid Schiff and Congo red were positive. The patient was treated with carbon dioxide (CO2) laser with improvement after one session. However, the patient expired due to complications of renal failure.

Conclusion: Colloid milium has been hypothesized to occur as a result of actinic degeneration of elastic fibers or collagen as suggested by its common appearance on sun-exposed skin. However, there are other reports of involvement of non-sun exposed areas as described in our case. Iron overload and increased oxidative stress in CKD may cause elastic tissue alteration which may explain the occurrence of lesions even in non-sun exposed areas.

Citation

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Keywords

colloid milium, CO2 laser, chronic kidney disease

 

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