A novel presentation of multiple milium‐like syringomas on the lower legs of an elderly male.

Notably, a Fontana-Masson stain did not highlight melanin pigment in the epithelial cells lining the cyst, supporting that the cyst was not of epidermal origin (Figure 4). However, unlike in MSL, in an eccrine duct milium an eccrine duct penetrates into the cyst wall at its base, forming a circular path within the wall and opens into the inner cavity of the cyst. Clinically, the differential diagnosis of MLS also includes adnexal tumors such as hidrocystomas, as well as cysts such as milia and vellus hair cysts. In contrast, in our case serial sections did not show any eccrine duct opening into the cyst wall, and no CEA-positive ductal structures or epithelial cells were seen within the cyst wall. [Extracted from the article]