Close-up of an eye with milia-like bumps on the eyelid, resembling a constellation.

Milia-Like Bumps on Your Eyelid? Understanding and Treating Idiopathic Calcinosis Cutis

Lena Kashyap in Health & Wellness November 2025 • 3 min read.

"Recurrent milia-like bumps on the eyelid could be a rare form of calcinosis cutis. Learn about this condition, its causes, and treatment options."

Milia-like idiopathic calcinosis cutis (MICC) is a rare and distinctive skin condition characterized by small, white bumps resembling milia. These bumps appear due to calcium deposits in the skin. What sets MICC apart is that it is idiopathic, meaning it arises without a clear underlying cause in many cases. Most commonly found in children with Down syndrome, MICC can occasionally occur in individuals without this genetic condition.

Recently, a case of recurrent MICC was reported in a healthy 17-year-old Korean boy. This individual experienced a solitary whitish papule on his right upper eyelid, a recurrence six years after complete removal of a similar lesion in the same area. This case highlights the importance of recognizing MICC, even in individuals without Down syndrome.

The initial physical examination revealed a 5 mm firm, white papule. Further examination confirmed it to be similar to the milia previously observed. The patient’s physical and mental development were normal, and he denied any history of trauma or skin disorders at the site of the lesion. This unique presentation prompted a closer look into the nature of MICC and its potential causes.

What are the Key Characteristics of MICC?

Close-up of an eye with milia-like bumps on the eyelid, resembling a constellation.

MICC presents as smooth, firm, whitish papules that closely resemble milia. Occasionally, these papules may be surrounded by erythema (redness) or exhibit a central crust, indicating transepidermal elimination of calcinosis (a process where the calcium deposits are expelled through the skin). Due to its clinical appearance, MICC can be mistaken for other skin conditions, including:

Differential diagnoses to consider:

Warts
Epidermal cysts
Molluscum contagiosum
Syringomas

While the hands and feet are the most common sites for MICC, facial involvement is rare. The co-occurrence of MICC with palpebral or perilesional syringomas (benign tumors of the sweat glands) has been noted, particularly in children with Down syndrome.

What are the potential causes of MICC?

The exact pathogenesis of MICC remains elusive, but several theories have been proposed. These include premature aging processes (as seen in Down syndrome), abnormal calcium levels in fibroblasts, the role of eccrine sweat ducts in calcium deposition, and chronic inflammatory reactions triggered by micro-epidermal cysts. In the reported case, serum levels of calcium and phosphate were normal, and there was no evidence of calcified sweat ducts, suggesting a possible inflammatory reaction to an unidentified factor.

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Everything You Need To Know

What exactly is Milia-like Idiopathic Calcinosis Cutis (MICC), and how does it manifest?

Milia-like Idiopathic Calcinosis Cutis (MICC) is a rare skin condition marked by small, white bumps that closely resemble milia. These bumps, which are actually calcium deposits, typically appear on the eyelids. The term "idiopathic" signifies that the condition arises without a known underlying cause in many instances. The bumps can be smooth, firm, and whitish, and sometimes exhibit erythema (redness) or a central crust. These characteristics can lead to misdiagnosis, with conditions like warts, epidermal cysts, molluscum contagiosum, and syringomas being potential alternatives considered by medical professionals.

What are the potential causes or contributing factors behind the development of MICC?

The exact causes of MICC remain unclear, but several theories exist. These include potential factors like premature aging processes (particularly relevant in individuals with Down syndrome), abnormal calcium levels in fibroblasts (cells that produce connective tissue), the involvement of eccrine sweat ducts in calcium deposition, and chronic inflammatory reactions related to micro-epidermal cysts. In specific cases, as seen in the 17-year-old Korean boy, normal serum calcium and phosphate levels suggest other mechanisms are at play, such as a possible inflammatory response to an unidentified factor.

How is MICC different from other similar skin conditions, and why is it important to differentiate?

MICC is often mistaken for other skin conditions, like warts, epidermal cysts, molluscum contagiosum, and syringomas, due to its milia-like appearance. The key difference lies in the underlying cause; MICC involves calcium deposits, whereas the others have different origins. Accurate differentiation is crucial because it impacts treatment. Misdiagnosing MICC could lead to ineffective treatments designed for the other conditions. Furthermore, knowing the specific condition helps in understanding potential associations, such as the noted co-occurrence of MICC with palpebral or perilesional syringomas, especially in individuals with Down syndrome.

Where on the body does MICC typically appear, and is it commonly found in specific patient groups?

While MICC can occur on different parts of the body, it most commonly appears on the hands and feet. However, when it does occur on the face, it's a rare finding, typically affecting the eyelids. MICC is more frequently observed in children with Down syndrome. This patient group also has a higher propensity to have associated conditions, such as palpebral or perilesional syringomas. However, cases like the 17-year-old Korean boy highlight that MICC can also appear in individuals without Down syndrome, although this is less common.

What were the key findings in the reported case of the 17-year-old Korean boy with recurrent MICC, and what does this case illustrate?

The case of the 17-year-old Korean boy presented with a recurrent solitary whitish papule on his right upper eyelid, six years after a similar lesion was removed. The examination revealed a firm, white papule, similar to the previous milia. Notably, the patient's physical and mental development was normal, and he had no history of trauma or skin disorders at the site of the lesion. This case highlights that MICC can occur even in individuals without Down syndrome. It underscores the importance of recognizing MICC. The normal levels of calcium and phosphate also suggest that the condition may be related to an inflammatory response to an unknown factor rather than systemic issues.