Differential Diagnosis for Milia
- Single most likely diagnosis:
- Milia (primary or secondary): This is the most likely diagnosis due to the characteristic presentation of small, white, or yellowish bumps on the skin, often found on the face, particularly around the eyes, nose, and mouth. Primary milia are usually seen in newborns and resolve spontaneously, while secondary milia can occur at any age due to various factors such as skin damage, burns, or blistering skin conditions.
- Other Likely diagnoses:
- Keratosis pilaris: This condition presents with small, rough, sandpapery bumps on the skin, often on the arms, legs, buttocks, and cheeks, and can be mistaken for milia due to the similar appearance of small bumps.
- Comedonal acne: Although typically associated with blackheads and whiteheads, comedonal acne can sometimes present with small, flesh-colored bumps that might be confused with milia.
- Sebaceous hyperplasia: This condition involves the enlargement of sebaceous glands, leading to small, yellowish or flesh-colored bumps on the face, which can resemble milia.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Basal cell carcinoma: Although rare, basal cell carcinoma can sometimes present as a small, pearly bump, which might be mistaken for a milium. Given its potential for malignancy, it's crucial not to miss this diagnosis.
- Trichoepithelioma: A rare skin condition that can present with small, skin-colored bumps, trichoepithelioma is generally benign but can be confused with milia. Its importance lies in distinguishing it from other, potentially more serious conditions.
- Rare diagnoses:
- Steatocystoma multiplex: A rare genetic disorder characterized by multiple, small, sebaceous cysts that can resemble milia but are typically larger and more numerous.
- Eruptive vellus hair cysts: Another rare condition, characterized by the sudden onset of small, asymptomatic, follicular papules, which can be mistaken for milia due to their appearance as small bumps on the skin.