How would you treat this persistent papule?

DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas

Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

Volume 51 - Issue 10 - October 2011


Dermclinic

A Photo Quiz to Hone Dermatologic Skills

Case 3:
A 50-year-old woman is concerned about a persistent white papule that erupted on her chest a few months ago. The lesion is asymptomatic.

What does this look like to you?

A. Bacterial folliculitis.
B. Yeast folliculitis.
C. Molluscum contagiosum.
D. Milium.
E. Epidermoid cyst.



(Answer on next page.)


Dermclinic—Answer

Case 3: Milium

Milia, D, are keratinaceous cysts that are common in children and middle-aged women. Primary milia, as seen in this patient, develop without any predisposing factors, whereas trauma is the most common cause of secondary milia. Simple excision and drainage is effective treatment.

Bacterial and fungal infections do not manifest as asymptomatic, solitary lesions that last for months. Molluscum have an umbilicated center. Milia arise on the surface of the skin, whereas epidermoid cysts are subcutaneous lesions.