Milia en plaque: a new site

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.

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.

Variants of milia successfully treated with CO(2) laser vaporization

BACKGROUND

Milia are a usual consultation in dermatologic practice and optimal treatment modalities are not established.

OBJECTIVE

To evaluate the efficacy and the safety of CO(2) laser vaporization in the treatment of milia.

METHODS

We report four patients, aged from 12 to 50 years old, with different variants of milia: milia en plaque, milia post-photodermatitis, multiple eruptive milia and milia post-trauma. They were treated with the CO(2) laser in superpulsed and focused mode at 2 W/cm(2), with two passes in each session. The follow-up was 12-36 months.

RESULTS

All patients showed marked improvement after a few sessions of CO(2) laser. No-one had recurrence or noticeable side effects.

CONCLUSION

The CO(2) laser is an option in adult and child patients with multiple milia lesions or milia en plaque, obtaining good cosmetic results with minimal side effects.

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.