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June 2006

Colloid Milium: A Histopathologic Mimicker of Nodular Amyloidosis

Arch Dermatol. 2006;142(6):781-798. doi:10.1001/archderm.142.6.784

A 42-year-old white man presented for a second opinion of asymptomatic lesions on his face and hands that had been present for 2 years. Physical examination revealed orange-brown coalescing translucent papules on the bilateral temples and zygomatic cheeks (Figure 1) as well as skin-colored papules on the dorsal hands. Histopathologic examination of lesional skin from the left zygoma and left dorsal hand showed expansion of the upper dermis by amphophilic amorphous material (Figure 2). The dermatopathologist's initial impression was that the patient had nodular amyloidosis. However, he agreed that the diagnosis was colloid milium after reading the clinician's impression.