Milia en plaque arising in discoid lupus erythematosus

Lichen planus follicularis tumidus

In this work, the authors described a case of a patient with lichen planus follicularis tumidus (LPFT), an extremely rare variant of lichen planus. The article provides an overview of literature on clinical features characterizing this rare condition. Differential diagnosis as well as treatment of this condition is considered.

 

Milia En Plaque as a Distinct Follicular Hamartoma With Cystic Trichoepitheliomatous Features

Milia en plaque (MEP) is an uncommon disorder characterized by an erythematous plaque containing numerous milia. The pathogenesis of MEP is not clear. The authors report a man with an erythematous plaque on the right retroauricular area, containing numerous white-yellow cysts varying in size. Histological examination showed that multiple cystic structures at various levels of the dermis that were lined by stratified squamous epithelium and contained keratinous material-these findings were consistent with the diagnosis of multiple milia. In addition to epidermal cysts, however, the lesion consisted of a branched proliferation of pale-staining keratinocytes lined with basal keratinocytes budding from the overlying epidermis. Moreover, some cysts were formed within the branched epithelial proliferation, had thicker cyst walls than the ordinary milium, or had irregular or branched projections toward the surrounding dermis. From these findings, the authors conclude that MEP is a distinct follicular hamartoma with cystic trichoepitheliomatous features.

Congenital Milia En Plaque

Milia en plaque is a rare, benign, localized, entity typically seen in adults after the third decade of life. Although there have been a few cases described in children, we describe the first case in a newborn.

Bilateral Extensive Periorbital Milia en Plaque Treated with Electrodesiccation

Background:

Milia en plaque (MEP) is a rare form of milia. Only 25 cases of this rare condition have been reported to date ( MEDLINE search). Only one previous case of MEP has been treated with electrodesiccation.

Objective:

To report a new case of this rare condition and present the outcome with electrodesiccation.

Conclusion:

The case is being reported here to highlight the features of this rare but now well-recognized dermatologic condition, which has been reported increasingly in the recent past, to discuss the various treatments tried, and to share our experience of treating patients with the simple, inexpensive, easily available, and nonsophisticated office procedure of electrodesiccation.

Milia en plaque of the nose: report of a case and successful treatment with topical tretinoin

Milia are benign, superficial keratinaceous cysts that present as fine, small white papules. Milia en plaque is a rare, challenging-to-treat variant most often seen in the posterior auricular region. A total of 9 cases of milia en plaque have been reported in the pediatric literature to date. We report a case of milia en plaque of the nose in a 7-year-old boy, a novel site of involvement in the pediatric population, and successful treatment with the use of topical tretinoin. Topical retinoids offer an effective treatment option for the management of milia en plaque in the pediatric population.

Milia en plaque: three new pediatric cases

Milia en plaque (MEP) is an unusual and extremely rare clinical variant of milia, characterized by multiple milia-like lesions overlying an erythematous edematous plaque with histologic findings consistent with milia. MEP tends to affect the middle-aged patients and shows a predilection for women. Among children, this entity is rarely described and, to our knowledge, only four cases have been reported to date in the dermatologic literature. We add three new cases of children, one of whom had an unusual site of presentation.

Milia en Plaque Successfully Treated by Dermabrasion

BACKGROUND

Milia en plaque is a rarely described benign lesion characterized by milia within an erythematous base, usually located periauricularly. No optimal treatment is known.

OBJECTIVE

To illustrate by a case report the clinical presentation and effect of dermabrasion on milia en plaque.

METHODS

A 60-year-old woman with milia en plaque at the mandibular ridge was treated with dermabrasion using a diamond fraise.

RESULTS

Complete regression of the lesion was seen at a follow-up of 6 months.

CONCLUSION

Dermabrasion seems a suitable treatment for milia en plaque.

Milia en plaque: a case report and review of the literature

BACKGROUND

Milia en plaque (MEP) is an unusual entity with a distinctive clinicohistologic appearance. Optimal treatment is unestablished, particularly for MEP located on difficult anatomic areas.

OBJECTIVE

To illustrate by a case report the clinical presentation and management of MEP.

METHODS

A 35-year-old woman with numerous tiny cysts within an slightly erythematous base in unilateral periorbital distribution is described. Histology revealed epidermal cysts arranged within the entire dermis.

RESULTS

Treatment with chemical exfoliating agents, manual extraction, and topical photodynamic therapy resulted in partial improvement.

CONCLUSION

Dermatologists should become familiar with this peculiar condition, being significantly rare possibly because of underreporting or misdiagnosis. New treatment procedures must be tried to achieve a successful cosmetic result with minimal risks.

Milia en plaque: a new site

A 35-year-old Kuwaiti field worker presented with a history of an asymptomatic, erythematous plaque on the right side of the nasal bridge. It soon extended to the malar area, being studded with multiple yellowish papules (Fig. 1). He denied any history of photosensitivity, drug intake, local trauma, topical applications, or ionizing radiations to that area. Examination revealed an erythematous, 1.5 x 3 cm plaque on the right nasal fold, extending to the malar area, overlain by a group of tiny yellowish papules (15-20 in number). He also had a few discrete milia on the right cheek. The histology (Fig. 2) revealed multiple keratin-filled cysts, surrounded by a dense lymphocytic infiltrate, findings consistent with milia; 0.05% tretinoin was prescribed twice daily for 1 month without improvement; minocycline, 100 mg daily, was then employed, and at 1 month of follow-up there was a significant decrease in erythema and milia count.

Lichen planus associated with milia

The formation of milia is well recognized in both bullous and inflammatory dermatoses. There are several reports of milia developing in a rare variant of lichen planus pilaris known as lichen planus follicularis tumidus (LPFT), but the association of milia with other types of lichen planus (LP) has not been documented in the literature. We report five patients who developed milia during the course of either drug-induced or idiopathic LP and one in whom milia developed in a lichenoid tattoo reaction. Milia were noted to occur transiently during the resolving phase of LP. Most cases were severe enough to warrant treatment with systemic steroids. The association of milia with LP is not restricted to the rare clinical variant LPFT. We speculate that a severe lichenoid reaction with basal layer degeneration may precipitate the formation of milia in some cases of LP.