Milia en plaque: a new site

A 35-year-old Kuwaiti field worker presented with a history of an asymptoma tic, erythematous plaque on the right side of the nasal bridge. It soon ext ended 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 rev ealed an erythematous, 1.5 x 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 histolog y (Fig. 2) revealed multiple keratin-filled cysts, surrounded by a dense ly mphocytic infiltrate, findings consistent with milia; 0.05% tretinoin was p rescribed twice daily for 1 month without improvement; minocycline, 100 mg daily, was then employed, and at 1 month of follow-up there was a significa nt decrease in erythema and milia count.