Congenital Milia With Alopecia and Multisystem Anomalies in Oral-Facial-Digital Syndrome Type 1.

Oral-facial-digital syndrome type 1 (OFD1) is an X-linked dominant ciliopathy characterized by facial, oral, and digital anomalies, often with neurological involvement. We report an 11-month-old girl presenting with multiple congenital milia on the cheeks, forehead, and auricular helices, accompanied by sparse wiry hair, partial occipital alopecia, and trichoscopic features of pili torti and comma-shaped black dots. Additional findings included craniofacial and oral anomalies, brachydactyly, preaxial polydactyly type 1 (PPD1), and agenesis of the corpus callosum with intracerebral cysts. This case highlights the diagnostic significance of congenital milia as an early clue for recognizing OFD1.