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

Primary Localized Cutaneous Nodular Amyloidosis Presenting as Milia: An Unusual Clinical Manifestation

Primary localized cutaneous nodular amyloidosis (PLCNA) is rare and clinically noncharacteristic, presenting mostly as plaque-like lesions. We report a case of a progressively larger erythematous plaque following a contusion of the skin on the right zygomatic area, which was strangely covered with recurrent scattered 2 mm whiteish blisters to the extent that it was misdiagnosed as a herpesvirus infection several times over a decade. Pathology and special staining diagnosed nodular amyloidosis with milia.

Eruptive milia during isotretinoin therapy

Isotretinoin (13-cis-retinoic acid) is a synthetic vitamin A derivative that is effective in the treatment of recalcitrant, nodulocystic acne. To our knowledge, there are no reports in the medical literature of milia as a side effect of isotretinoin. We report a case of eruptive facial milia in the setting of isotretinoin treatment for acne.

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.