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Year : 2013  |  Volume : 58  |  Issue : 4  |  Page : 322-323
Curious translucent papules over vitiliginous patches


Department of Dermatology, Venereology and Leprology, Seth G.S Medical College and K.E.M Hospital, Mumbai, India

Date of Web Publication25-Jun-2013

Correspondence Address:
Shekhar S Haldar
Department of Dermatology, Venereology and Leprology, Seth G.S Medical College and K.E.M Hospital, Mumbai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.113973

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How to cite this article:
Haldar SS, Gutte R, Doshi BR, Khopkar US. Curious translucent papules over vitiliginous patches. Indian J Dermatol 2013;58:322-3

How to cite this URL:
Haldar SS, Gutte R, Doshi BR, Khopkar US. Curious translucent papules over vitiliginous patches. Indian J Dermatol [serial online] 2013 [cited 2019 May 24];58:322-3. Available from: http://www.e-ijd.org/text.asp?2013/58/4/322/113973


A 54-year-old man with acrofacial vitiligo of 15 years duration presented with gradual onset of progressively increasing depigmented, translucent, skin-colored raised lesions strictly restricted to the vitiliginous patches on the dorsum of the hands and feet since the past 1 year. Clinical examination revealed discrete, closely-spaced, translucent, shiny, and dome-shaped papules of varying size between 1 to 3 mm [Figure 1]. When nicked with a scalpel, a papule extruded clear, gelatinous substance. No lesions were observed on other exposed areas or covered areas of the body. The patient had a history of chronic exposure to UV radiation (20 years duration) and regular contact with lubricating petroleum products (14 years duration) as part of his outdoor occupation [Figure 2].
Figure 1: Translucent, shiny, and dome-shaped papules, varying from 1 to 3 mm

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Figure 2: Photomicrograph showing homogenous, moderately eosinophilic, clefted, amorphous material in the upper reticular dermis and overlying atrophic epidermis (arrows) (H and E, ×100)

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The patient was otherwise healthy, and there was no history of similar lesions in his family. Other routine laboratory investigations were within normal limits.

Histopathological findings and special staining by Van Gieson are shown in [Figure 3] and [Figure 4].
Figure 3: Spindle-shaped fibroblasts were seen lined along the colloid clefts with intact blood vessels within these clefts (arrows) (H and E, ×200)

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Figure 4: Photomicrograph showing positive yellow-colored staining of the deposit with Van Gieson stain (arrow) (Van Gieson, ×200)

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1.Holzberger PC. Concerning adult colloid milium. Arch Dermatol 1960;82:711-6.  Back to cited text no. 1
    
2.Findlay GH, Morrison JG, Simson IW. Exogenous ochronosis and pigmented colloid milium from hydroquinone bleaching creams. Br J Dermatol 1975;93:613-22.  Back to cited text no. 2
    
3.Lewis AT, Le EH, Quan LT, Krishnan B, Schulmeier J, Hsu S. Unilateral colloid milium of the arm. J Am Acad Dermatol 2002;46 (2 Suppl Case Reports):S5-7.  Back to cited text no. 3
    
4.Kobayashi H, Hashimoto K. Colloid and elastic fibre: Ultrastructural study on the histogenesis of colloid milium. J Cutan Pathol 1983;10:111-22.  Back to cited text no. 4
    
5.Hashimoto K, Black M. Colloid milium: A final degeneration product of actinic elastoid. J Cutan Pathol 1985;12:147-56.  Back to cited text no. 5
    
6.Innocenzi D, Barduagni F, Cerio R, Wolter M. UV-induced colloid milium. Clin and Exp Dermatol 1993;18:347-50.  Back to cited text no. 6
    
7.Kirtak N, Inaloz HS, Karakok M, Ozgoztasi O. A case of adult colloid milium with chronic sun exposure. Int J Dermatol 2002;41:936-8.  Back to cited text no. 7
    
8.Graham JH, Marques AS. Colloid milium: A histochemical study. J Invest Dermatol 1967;49:497-507.  Back to cited text no. 8
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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