Milia en Plaque: A Case Report and Review of the Literature

Abstract

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 em placa

“…[1][2][3] Around 30 such cases have been reported in the medical literature. 3 MEP predominantly affects the periauricular and periorbital regions of adults, with a female/male ratio of 2:1.…”

“…However, the condition has also been described both in infancy and in senescence and at other sites on the face such as the nose, forehead and in the perimandibular, malar and supraclavicular regions. 1,[4][5][6] Evidence shows that the primary forms of milia originate in the hair follicle infundibulum, whereas the secondary forms may originate in various annexal structures such as the sweat ducts, sebaceous glands and hair follicles. 1,7 Clinical differential diagnosis is made between MEP and secondary milia with plaques and other conditions that may simulate MEP.…”

“…1,[4][5][6] Evidence shows that the primary forms of milia originate in the hair follicle infundibulum, whereas the secondary forms may originate in various annexal structures such as the sweat ducts, sebaceous glands and hair follicles. 1,7 Clinical differential diagnosis is made between MEP and secondary milia with plaques and other conditions that may simulate MEP. Cases of secondary milia en plaque have been described in patients with lupus erythematosus, pseudoxanthoma elasticum, lichen planus follicularis tumidus and lichenoid eruption, contact dermatitis, folliculotropic mycosis fungoides with cysts and comedones, follicular mucinosis and in patients in use of cyclosporine following organ transplantation, although doubt remains with respect to this last group.…”

“…Milia are classified as primary when their onset is spontaneous and secondary when they appear following trauma (such as a burn, dermabrasion or ablative laser resurfacing), inflammatory skin diseases (particularly those involving the basement membrane zone such as subepidermal bullous diseases) or the use of topical medication (topical corticosteroids, 5-fluoruracil) or systemic drugs (cyclosporin and benoxaprofen). 1,2 Milia en plaque (MEP) is a rare form of primary milia characterized by the presence of milia on an erythematous-edematous or infiltrated erythematous plaque. The condition was first described by Balzer and Fouquet in 1903 and was denominated MEP by Hubler et al in 1978.…”

“…The condition was first described by Balzer and Fouquet in 1903 and was denominated MEP by Hubler et al in 1978. 1 Although it is a benign and generally asymptomatic condition, treatment management and clinical and histological differential diagnoses are challenging. The present report describes a case of retroauricular milia en plaque.…”