Differential Diagnosis for Milia-like Lesions on Adult Face with Mild Itchiness
- Single most likely diagnosis
- Keratosis Pilaris: This condition is characterized by small, rough, sandpaper-like bumps on the skin, often accompanied by mild itchiness. The face can be involved, and the presentation of milia-like lesions is consistent with this diagnosis.
- Other Likely diagnoses
- Milia: These are small, white bumps that occur when keratin, a protein, becomes trapped under the skin. They are common in adults and can appear on the face, often without significant symptoms other than their appearance.
- Primary Cutaneous Amyloidosis: This condition can present with milia-like lesions and is associated with the deposition of amyloid in the skin, leading to papular or nodular lesions that may itch.
- Follicular Keratosis (Phrynoderma): Although more commonly associated with dry skin and a rough texture, follicular keratosis can sometimes present with small, bumps resembling milia, especially in the context of nutritional deficiencies or environmental factors.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Cutaneous Lymphoma (e.g., Mycosis Fungoides): While rare, cutaneous lymphomas can present with a wide range of skin manifestations, including lesions that might resemble milia. Given the potential severity of lymphoma, it's crucial to consider this in the differential diagnosis, especially if there are other systemic symptoms or if the lesions do not respond to typical treatments.
- Leukemia Cutis: Involvement of the skin by leukemia can result in a variety of lesions, and though uncommon, could potentially mimic milia-like lesions. The presence of systemic symptoms or other signs of leukemia would prompt a more urgent investigation.
- Rare diagnoses
- Colloid Milium: A rare condition characterized by the accumulation of colloid material in the skin, leading to small, translucent or yellowish papules. It's associated with sun exposure and can appear on the face.
- Steatocystoma Multiplex: An autosomal dominant condition characterized by multiple, small, cystic lesions that can resemble milia. These lesions are usually filled with a soft, cheesy material and can appear on various parts of the body, including the face.
- Eruptive Vellus Hair Cysts: Although these cysts are more commonly found on the chest and arms, they can occasionally appear on the face and might be mistaken for milia-like lesions due to their small size and appearance.