Background.
Bohn’s pimples are benign keratotic cysts that often present as tiny white protrusions on the face of newborns. They are called bohn’s nodules and Epstein’s pearls if they occur at the gingival margin and midline of the oral palate. There are two types of milia: primary and secondary. Most primary cornea is a congenital cornea in newborns. Primary milia can be associated with or disseminated from a variety of genetic skin disorders. Secondary milia are associated with underlying skin conditions, medications, or trauma.
In 2008, Berk and Bayliss classified cornea into the following types.
Primary.
Congenital; benign primary cornea in children and adults; plaque-type cornea; nodular clustered cornea; multiple eruptive cornea; nevus-like pigment loss with cornea; and cornea associated with hereditary skin disease.
Secondary milia.
Disease-associated cornea; drug-associated cornea; trauma-associated cornea.
Congenital cornea occurs in nearly half of healthy newborns and is often detected at birth; its appearance can be delayed in premature infants. The rash resolves spontaneously within a few weeks. It often occurs on the face and nose.
Benign acquired papules in children and adults often occur spontaneously and do not resolve on their own if left untreated. It often occurs on the eyelids, cheeks, forehead, and genitalia.
Multi-transmitted eruptive cornea presents as an acquired generalized cornea that occurs suddenly over a period of weeks to months. It may be associated with a genetic disorder or may be an autosomal dominant trait with no other significant abnormalities. Most cases occur sporadically.
Inherited dermatological disorders associated with cornea include basal cell nevus syndrome, Rombo syndrome, Brooke-Spiegler syndrome, congenital thick nail syndrome type 2, and anaplasia with papulopapular lesions.
In children, traumatic papules are most commonly seen after abrasion or burns. Acanthosis cornea can also occur after skin grafting. It can also be associated with maculopapular dermatoses, such as herpetic epidermolysis bullosa and late-onset dermal porphyrias.
Pathophysiologic mechanisms.
Histologic studies support that primary cornea originates from the sebaceous gland site in the funnel of the hair follicles of the fine hairs, whereas secondary cornea often originates from the exocrine sweat ducts.
Medical history.
Cornules are usually asymptomatic.
Congenital papules often appear at birth and often resolve on their own.
Active cornea often persists if left untreated.
In the case of acquired milia, a prior history of trauma or maculopapular dermatosis may be observed.
Clinical presentation.
Typical lesions present as 1-3 mm in size, white to yellow, arching, smooth papules.
The rash is single or multiple.
Congenital milia are most often located on the face, and the nose is often involved.
Benign acquired milia in children and adults often occur on the ah forehead, cheeks, eyelids, and genitalia.
Cornules can be distributed in clusters.
Plaque papules present as red plaques studded with multiple cornea. The plaques can be several centimeters in size.
Multifocal eruptive cornea often occurs on the face, upper trunk, proximal extremities, and groin.
Treatment.
Congenital cornea does not need to be treated because it can go away on its own. If older children have multiple cornea, topical retinoids can be applied.
Surgical treatment.
A simple surgical intervention can be used. It is usually painless and most do not require anesthesia.11 A razor blade or hypodermic needle can be used to pick out the rash. An acne squeezer can also be used. Other tools include a blunt-tipped spatula or paper clip.