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 × 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.

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