(Last Updated On: December 14, 2018)
Authors: Kei George J. Rebolledo, MD; Zharlah Gulmatico-Flores, MD, FPDS; Mercedes Buenviaje-Beloso, MD, FPDS


Milia en plaque (MEP) is a rare disorder distinguished clinically by numerous confluent milia on an erythematous base. No more than sixty cases have been reported in literature, majority of which are located on the post-auricular area. Although benign, it poses a cosmetic predicament among patients. Treatment options are limited, including various topical, systemic, and procedural modalities that were comprehensively reviewed in previous literature. None have been established to be optimal, especially when utilized as monotherapy. We report a case of a 25-year-old Filipino female with multiple white-yellow domed papules at the nasal tip, a novel site of MEP in the adult population. Histopathology revealed multiple epithelial-lined cystic structures filled with keratin on the dermis, typical of MEP. We treated the patient with a multimodal approach of utilizing topical tretinoin, manual extraction, electrocautery, and 30% trichloroacetic peel which led to complete resolution with no recurrence and scarring after a follow-up of six months. This led us to conclude that this cost-effective and practical multimodal approach is an effective treatment for MEP.





Milia en Plaque, MEP, Milia, Erythematous

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