Milia — RACP Paediatrics MCQ

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A newborn has multiple small white papules on the nose, cheeks, and chin present from birth. They are 1-2 mm, firm, and non-inflamed. What is the most likely diagnosis?

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Correct answer: B — Milia

Small white/yellow papules on the face (especially nose) present from birth are milia – retention cysts of the pilosebaceous follicle containing keratinous material. They are present in up to 40% of newborns and resolve spontaneously within weeks. No treatment is needed. Epstein pearls are the mucosal equivalent found on the palate.

Reference: RCH Melbourne – 2023 – Neonatal Skin CPG; RACP Paediatric Curriculum – Neonatology