colloid milia
Introduction
Introduction to gum-like millet The disease is also known as colloidpseudomilium or cutaneus colloiddegeneration, which has been translated into colloidal squamous cell carcinoma or colloidal millet rash. Originally reported by Reuter and Way in 1942, the rash occurs on the face and back of the hand, mostly yellowish, round and translucent flat papules from miliary to lentils, much like blisters. After being detached with a needle, the viscous gel-like substance can be extruded. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: swelling pruritus
Cause
Glucose-like measles
(1) Causes of the disease
It is not fully understood that skin lesions are more common in exposed areas and may be related to sun exposure. It is generally considered that the disease is divided into two types: children and adults. The former occurs in children or adolescence, and gradually disappears after puberty. There is often a family relationship. Is an autosomal dominant inheritance, adult type is often exposed to sunlight for a long time in adulthood, especially in tropical outdoor workers, oil workers are prone to disease, the disease has a familial incidence, more men than women.
(two) pathogenesis
The pathogenesis is unknown and may be autosomal dominant.
Prevention
Colloidal malignant rash prevention
Avoid long-term sun exposure on the skin.
Complication
Colloidal measles complication Complications, swelling, pruritus
Because the skin is often accompanied by itching, and the skin is broken, the skin integrity is destroyed, so it can be caused by bacterial infection or fungal infection caused by scratching, usually secondary to low body, or long-term use of immunosuppressants and fungi with nail fungus Infected patients, such as concurrent bacterial infections, may have symptoms such as fever, swelling of the skin, ulceration, and purulent secretion. Severe cases can lead to sepsis, which should be brought to the attention of clinicians.
Symptom
Glucose-like millet rash symptoms Common symptoms Itching epidermis keratinized papule nodules PAS staining positive subcutaneous fat granules
Excessive keratinization of the epidermis, atrophy of the acanthus, flattening of the epidermis, and a significant enlargement of the dermal papilla layer. The upper layer of the dermis can be seen as a gel-like substance with no structural homogeneity, or it can be transparently denatured, surrounded by normal collagen fiber bundles, and the boundary is clear. In the denatured collagen material, fissures and a few spindle-shaped ruptured nuclei are visible. Gel-like substances such as HE staining are eosinophilic, lighter or weakly basophilic than normal collagen, PAS staining positive, amylase resistant, and Van Gieson staining. It is yellow, the elastic fiber can be broken, and a small amount of lymphocytes infiltrate around the gelatinous substance. When the child is sick, it is translucent, yellowish at the exposed part, and the needle to the soybean is large, round or not shaped, flat or mound. The raised papules are often symmetrically distributed on the face and back of the hand. They are also scattered on the forehead, cheeks or nose. The papules are slightly firmer than the surrounding skin and do not fuse with each other, but often cluster, after chronic, to adulthood. Disappeared, generally no symptoms.
In adults, the rash often occurs in exposed areas, such as the forehead, around the eyelids, ears, neck, forearms and back of the hand, in addition to a few large transparent papules, but also visible light yellow, orange or normal skin color Nodules or plaques, the top of the former can be seen in the small nest or attached to the small sputum. Sometimes the telangiectasia can be seen on the plaque. After chronic, the elderly who are often exposed to the sun are prone to hair. Men are more than women, and sometimes they are slightly itchy.
Examine
Glucose-like malignant examination
Clinical skin examination: The rash is usually translucent, pale yellow, needle-to-somatic large, round or non-plastic, flat or mound-like papules, often symmetrically distributed. Occurs on the face and back of the hand, also spread on the forehead, cheeks or nose.
Pathological examination: hyperkeratosis of the epidermis, atrophy of the acanthosis, flattening of the epidermis. The dermal papilla layer is significantly enlarged, and there is no structurally homogeneous gel-like substance in the upper layer of the dermis, or it is transparently denatured. Surrounded by a bundle of normal collagen fibers, the boundary is clear. A fissure and a few spindle-ruptured nuclei are visible in the denatured collagen material. Gummy-like substances such as HE staining are eosinophilic, which is lighter or weakly basophilic than normal collagen. PAS staining was positive.
Other tests: Blood routine and C-reactive protein tests should be performed on patients with co-infection.
Diagnosis
Diagnosis and identification of gum-like millet
It is easy to diagnose according to the manifestations of rash and the characteristics of pathological changes.
1. The millet rash has a white papule, which can be squeezed out after the tip of the needle to extrude the pearl-like granules, and the epithelial cyst can be seen in the upper layer of the dermis.
2. The lichen planus papules are red or purple-red, opaque, and there is no gel-like substance in the rash. It occurs in the flexor of the forearm, itching, basal cell liquefaction and degeneration, and the cells between the epidermis and the dermis are infiltrated with no gelatinous substance.
3. The skin amyloid rash is light brown, round or hemispherical bulge, the calf stretches more often, itchy, rash has amyloid deposits, Congo red staining positive, Van Gieson staining is reddish, methyl violet staining In purple.
