Adv Pediatr Surg.  2019 Dec;25(2):60-62. 10.13029/aps.2019.25.2.60.

Recurrent Congenital Milium of the Nipple

• Shin HB
• Jeong YJ

• KMID: 2466401
• DOI: http://doi.org/10.13029/aps.2019.25.2.60

Abstract

Congenital milia of the nipple are extremely rare, and standard treatment has not yet been established because nipple preserving excision is problematic due to the location. Although most reports show excisional biopsy resulting in good outcomes without recurrence, there is a lack of consensus about treatment modality, with several studies suggesting that incisional evacuation by needle, or a "˜wait and see' approach represent sufficient treatment. This case report is about a recurrent case after incisional evacuation for congenital milium of the nipple. We recommend nipple preserving excision with exfoliation of the milial capsule as being the most appropriate treatment modality for congenital milium of the nipple.

Keyword

Epidermal cyst; Nipples; Needles; Newborn

MeSH Terms

Biopsy
Consensus
Epidermal Cyst
Humans
Infant, Newborn
Needles
Nipples*
Recurrence

Figure

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  Fig. 1 The congenital milium of the nipple. (A) Gross finding of patient at the first visit. (B) Ultrasonography finding. (C) First operative procedure: incisional evacuation by needle.

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  Fig. 2 Pathologic finding: stratified squamous epithelium with lamellated keratinous material.

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  Fig. 3 The recurrent milium of the nipple. (A) Gross finding of patient at recurrence. (B) Second operative procedure: excision.

Reference

1. Dilek N, Dilek AR, Saral Y, Sehitoglu I. Epidermoid cyst on the nipple: a rare location. Breast J. 2014; 20:203–234.

2. Ferreira MG, Salgado MB. Congenital milium of the nipple. Pediatr Dermatol. 2017; 34:e28–e29.

3. Marchesi A, Parodi PC, Palitta G, Marchesi M, Vaienti L. A “polypoid” nipple: an unusual case of epidermoid cyst. J Plast Reconstr Aesthet Surg. 2014; 67:e27–e28.

4. George DE, Wasko CA, Hsu S. Surgical pearl: evacuation of milia with a paper clip. J Am Acad Dermatol. 2006; 54:326.

5. Jain S, Sarkar R, Garg VK, Khurana N. Epidermal inclusion cyst or giant milium of the nipple. Indian J Dermatol Venereol Leprol. 2012; 78:103–105.

6. Park J, Kim JI, Kim DW, Hwang SR, Jeong YJ, Yun SK. Congenital primary milium of the nipple. Dermatol Sin. 2014; 32:129–130.