CASE REPORT
Year: 2019 • Volume: 2 • Issue: 3 • Page: 94-95

MILIA EN PLAQUE

Deepak Sharma1, Asit Mittal1, Manisha Balai1, Neelima Bansal1
1Department of Dermatology, RNT Medical College, Udaipur, Rajasthan

Corresponding Author:
Dr. Asit Mittal
Senior Professor, Department of Dermatology, Venereology & Leprology R.N.T. Medical College, Udaipur, 313001(Raj.)

Email: asitmittal62@gmail.com

How to cite this article:
Sharma D, Mittal A, Balai M, Bansal N. Milia en plaque. JDA Indian Journal of Clinical Dermatology 2020;3:

Abstract
Discrete milia are common whereas milia en plaque is rarely encountered entity. Althoughreason for postauricular localization in not
yet understood, repeated trauma could be predisposing factor.

Keywords: Milia , Retroauricular, Middle age

Introduction
Milia are subepidermal keratin cysts that can be seen in all age groups from neonate to elderly. Milia can be primary or secondary to various skin disorders. It frequently appears over cheeks and eyelids.[1] Although discrete milia are common, milia en plaque is rarely encountered. Here, we are reporting two patients where milia en plaque found on retro-auricular skin.
Case 1
A 32-year old male, farmer by occupation, presented to dermatology OPD with multiple skin coloured lesions on retroauricular skin, present for last three years. Patient denied use of eye glasses, any topical cream or any possible trauma. Clinical examination revealed 3 x 2 cm size plaque composed of multiple yellowish papules on retroauricular skin (Figure 1a,b). Fig 1a,b

Figure 1a: Erythematous plaque studded with multiple shiny yellow colored milia over left retroauricular area. 1b : Milia en plaque at right retroauricular space

Histopathological examination revealed multiple concentric lamellar keratin filled cysts lined by keratinized stratified squamous epithelium in dermis (Figure 2a). Mature or fully developed cysts were lined by single layer whereas evolving cystlined by multiple layers. Peri-cystic and peri-appendegeal mononuclear cell infiltration was noted[1] (Figure 2b). Diagnosis of milia en plaque was made and patient was asked for local application of tretinoin 0.025% cream. Patient was however loss to follow up.
Case 2
A 35-year-old woman, presented with closely aggregated milia on left retroauricular skin (Figure 3). Lesions were present for last six months. She gave history of wearing large ear-ring for 1 years. Cutaneous Examination showed 2×2 cm skin colored plaque composed of multiple milia with shiny yellowish surface. Patient did not give consent for histopathological examination. On the basis of morphological examination, diagnosis of milia en plaque was made.

Discussion

Figure 2a: 10x view of HPE of milia en plaque with multiple lamellar keratin filled cyst in superficial and deep dermis. 2b : 40x view of multiple cyst lined by single or multiple layer with peri-cystic and peri-appendegeal mononuclear cell infiltration

Milia can be considered primary appearing spontaneously, or secondary, caused by skin disease, trauma, or medications. Primary milia are small epidermoid cyst, 1-4mm in diameter , arise from lowest part of infundibulum of vellus hair follicle at the level of sebaceous gland. They are fixed and persistent. Primary milia may occur congenitally or shortly after birth in up to 50% newborns. Favourable sites are the face, especially nose, scalp, proximal extremities and upper trunk. They resolve over weeks.[2]

Secondary milia arises from eccrine duct or hair follicle, in order

Figure 3: Skincolored plaque with grouped milia forming milia en plaque over left retroauricular area.

to re-epithelise the eroded epidermis. They are transient and spontaneously disappear. Milia on palate are called Epstein pearls. Secondary milia can develop as a result of blistering skin disease, they also tend to occur after trauma such as dermabrasion, chemical peeling, ablative laser, skin grafting and

radiotherapy[2]. Long term use of topical corticosteroids and occlusive moisturizer can cause milia. Cyclosporine and 5-FU have been associated with development of milia.[3]

Milia en plaque is an inflammatory variant of milia. It shows predilection for the head and neck area, especially periauricular and periorbital area[4].This condition is more common in middle aged women.[2]

In both our cases lesions of Milia en plaque were present on retro-auricular skin.

First case mentioned here, had no prior risk factors like pre- existing skin lesions or any chronic trauma. It is possible that in second patient, history of wearing large ear rings might have acted as precipitating factor.

Milia en plaque is not common and reported only sparingly in literature. This prompted us to report these cases.

Reference
1. Kirkham N. Tumor and cyst of the epidermis. In: Lever ‘s histopathology of the skin (Elder D.E.).10th ed. Wolters Kluwer : Lippincott Williams and wilkins 2009; Page 802
2. James W.D, Berger T.G, Elston D.M. Epidermal Nevi, Neoplasm, and Cyst In. Andrews’ Diseases of the skin.12th edition : Elsevier 2016; Page 676-77.
3. Sharma R, Kumar B. Milia en Plaque. Indian J Dermatol Venereol Leprol 1995;61:365-6.
4. Lee DW, Choi SW,Cho BK. Milia en plaque. J Am Acad Dermatol 1994, 31:107.

2,680 comments on “MILIA EN PLAQUE

  1. The doctor lowered the dosage which helped the confusion and memory loss, but I was still very depressed and actually started to plan how I was going to kill myself and make it look like an accident lasix Norway Falling directly to the imperial city, although there is some disrespect to Gu Min, but now Nan Chu is not a dynasty in the world, if you enter through the palace gate, you will also lose your own prestige

  2. naturally like your web site however you need to take a look at the spelling on several of your posts. A number of them are rife with spelling problems and I find it very bothersome to tell the truth on the other hand I will surely come again again.

  3. I’m often to blogging and i really appreciate your content. The article has actually peaks my interest. I’m going to bookmark your web site and maintain checking for brand spanking new information.

  4. I’m often to blogging and i really appreciate your content. The article has actually peaks my interest. I’m going to bookmark your web site and maintain checking for brand spanking new information.

  5. I’m often to blogging and i really appreciate your content. The article has actually peaks my interest. I’m going to bookmark your web site and maintain checking for brand spanking new information.

  6. I’m often to blogging and i really appreciate your content. The article has actually peaks my interest. I’m going to bookmark your web site and maintain checking for brand spanking new information.

  7. Try to slowly read the articles on this website, don’t just comment, I think the posts on this page are very helpful, because I understand the intent of the author of this article.

  8. Hi there to all, for the reason that I am genuinely keen of reading this website’s post to be updated on a regular basis. It carries pleasant stuff.

  9. Very well presented. Every quote was awesome and thanks for sharing the content. Keep sharing and keep motivating others.

  10. You’re so awesome! I don’t believe I have read a single thing like that before. So great to find someone with some original thoughts on this topic. Really.. thank you for starting this up. This website is something that is needed on the internet, someone with a little originality!

  11. I am truly thankful to the owner of this web site who has shared this fantastic piece of writing at at this place.

  12. naturally like your web site however you need to take a look at the spelling on several of your posts. A number of them are rife with spelling problems and I find it very bothersome to tell the truth on the other hand I will surely come again again.

  13. Hi there to all, for the reason that I am genuinely keen of reading this website’s post to be updated on a regular basis. It carries pleasant stuff.

  14. You’re so awesome! I don’t believe I have read a single thing like that before. So great to find someone with some original thoughts on this topic. Really.. thank you for starting this up. This website is something that is needed on the internet, someone with a little originality!

  15. Very well presented. Every quote was awesome and thanks for sharing the content. Keep sharing and keep motivating others.

  16. For the reason that the admin of this site is working, no uncertainty very quickly it will be renowned, due to its quality contents.

  17. Hi there to all, for the reason that I am genuinely keen of reading this website’s post to be updated on a regular basis. It carries pleasant stuff.

  18. Hi there to all, for the reason that I am genuinely keen of reading this website’s post to be updated on a regular basis. It carries pleasant stuff.

  19. I’m often to blogging and i really appreciate your content. The article has actually peaks my interest. I’m going to bookmark your web site and maintain checking for brand spanking new information.

  20. naturally like your web site however you need to take a look at the spelling on several of your posts. A number of them are rife with spelling problems and I find it very bothersome to tell the truth on the other hand I will surely come again again.

  21. This is really interesting, You’re a very skilled blogger. I’ve joined your feed and look forward to seeking more of your magnificent post. Also, I’ve shared your site in my social networks!

  22. Thanks for a marvelous posting! I genuinely enjoyed reading it, you are a great author.I will always bookmark your blog and will often come back down the road. I want to encourage continue your great job, have a nice weekend!

  23. Hi there to all, for the reason that I am genuinely keen of reading this website’s post to be updated on a regular basis. It carries pleasant stuff.

  24. Thanks for a marvelous posting! I genuinely enjoyed reading it, you are a great author.I will always bookmark your blog and will often come back down the road. I want to encourage continue your great job, have a nice weekend!

  25. naturally like your web site however you need to take a look at the spelling on several of your posts. A number of them are rife with spelling problems and I find it very bothersome to tell the truth on the other hand I will surely come again again.

  26. naturally like your web site however you need to take a look at the spelling on several of your posts. A number of them are rife with spelling problems and I find it very bothersome to tell the truth on the other hand I will surely come again again.

  27. I do not even know how I ended up here, but I thought this post was great. I don’t know who you are but definitely you’re going to a famous blogger if you aren’t already 😉 Cheers!

  28. Great wordpress blog here.. It’s hard to find quality writing like yours these days. I really appreciate people like you! take care

  29. Hi there to all, for the reason that I am genuinely keen of reading this website’s post to be updated on a regular basis. It carries pleasant stuff.

  30. I’m often to blogging and i really appreciate your content. The article has actually peaks my interest. I’m going to bookmark your web site and maintain checking for brand spanking new information.

  31. I carry on listening to the reports speak about getting free online grant applications so I have been looking around for the most excellent site to get one. Could you advise me please, where could i get some?

  32. naturally like your web site however you need to take a look at the spelling on several of your posts. A number of them are rife with spelling problems and I find it very bothersome to tell the truth on the other hand I will surely come again again.

  33. You’re so awesome! I don’t believe I have read a single thing like that before. So great to find someone with some original thoughts on this topic. Really.. thank you for starting this up. This website is something that is needed on the internet, someone with a little originality!

  34. Can I just now say that of a relief to get somebody who actually knows what theyre speaking about on the web. You actually realize how to bring an issue to light and produce it important. Workout . need to look at this and fully grasp this side on the story. I cant think youre no more common because you definitely contain the gift.

  35. What’s Taking place i’m new to this, I stumbled upon this I have found It positively helpful and it has aided me out loads. I hope to give a contribution & help other users like its helped me. Good job.

  36. Sweet blog! I found it while browsing on Yahoo News. Do you have any tips on how to get listed in Yahoo News? I’ve been trying for a while but I never seem to get there! Thanks

  37. Good created details. It will likely be beneficial to anyone who employess that, as well as me personally. Carry on doing your work canr hold out you just read a lot more articles.

  38. I truly appreciate this post. I have been looking everywhere for this! Thank goodness I found it on Google. You have made my day! Thanks again..

  39. It’s really a nice and useful piece of info. I’m glad that you shared this useful info with us. Please keep us informed like this. Thanks for sharing.

  40. Howdy! Someone in my Myspace group shared this site with us so I came to take a look. I’m definitely loving the information. I’m book-marking and will be tweeting this to my followers! Superb blog and great style and design.

  41. This article weighs in as a heavy weight hitter in my opinion. The content is informative, but it’s also clear. This is right on point as far as I’m concerned.

  42. Can I just say what a relief to seek out someone who actually is aware of what theyre talking about on the internet. You undoubtedly know the way to bring an issue to light and make it important. More folks have to read this and understand this aspect of the story. I cant believe youre not more popular because you positively have the gift.

  43. i believe,Studies from it is simply total capacity, ingenuity is not competent, on the other hand we simply cannot eradicate keep in mind this a quality certification.

  44. I’m often to blogging and i in actual fact respect your content. The piece has actually peaks my interest. I’m going to bookmark your content and preserve checking for brand new information.

  45. hi!,I like your writing so much! share we communicate more about your post on AOL? I need an expert on this area to solve my problem. Maybe that’s you! Looking forward to see you.

  46. I was suggested this website by my cousin. I’m not sure whether this post is written by him as nobody else know such detailed about my difficulty. You are amazing! Thanks!

  47. I like what you guys are doing. Such smart work and reporting! Carry on with the excellent works guys. I have incorporated you guys to my blogroll. I think it’ll improve the value of my site.

  48. Very much, this process review is often the nicest at this outstanding field. Document harmonise to your findings but will thirstily expect to be your entire inward realises. Announcing appreciation will not only often be plenty of, towards the unique transparency affecting your crafting. I am able to promptly invest in ones feed to be able to well-versed of a typical update versions. Remarkable occupation and far achieving success within corporate business! Please justification the best negative Words which is not always brand new earliest language.

  49. certainly like your website but you have to check the spelling on quite a few of your posts. A number of them are rife with spelling problems and I find it very troublesome to tell the truth nevertheless I’ll certainly come back again.

  50. Votre étude : alors voilà quelques satisfaisants sujets de discussion cependant reste sceptique de la sincérité de vos taux affichés ici dans ce petit paragraphe

  51. I have caught great sites and I have caught not so wonderful blogs. This blog is very informationrmative in many ways and certainloy ranks in the former category. Really appreciate the information your providing use avid scaners!

  52. Hiya, I’m really glad I have found this information. Nowadays bloggers publish just about gossips and web and this is really annoying. A good site with interesting content, that is what I need. Thanks for keeping this web site, I’ll be visiting it. Do you do newsletters? Can’t find it.

  53. I conceive other website proprietors should take this website as an example , very clean and excellent user pleasant style . CHECK ME OUT BY CLICKING MY NAME!!!

  54. I just couldn’t depart your web site before suggesting that I really loved the usual info an individual provide in your visitors? Is going to be back incessantly in order to check out new posts

  55. Wonderful blog! I found it while surfing around on Yahoo News. Do you have any suggestions on how to get listed in Yahoo News? I’ve been trying for a while but I never seem to get there! Many thanks

  56. Particular paid google internet pages offer complete databases relating whilst personal essentials of persons while range beginning telephone number, civil drive public records, as well as criminal arrest back-ground documents.

  57. Awesome blog! Is your theme custom made or did you download it from somewhere? A design like yours with a few simple tweeks would really make my blog shine. Please let me know where you got your design. Thanks a lot

  58. Thank you, I’ve just been searching for info about this subject for a long time and yours is the best I have discovered till now. But, what in regards to the conclusion? Are you positive about the source?

  59. There are incredibly a lot of details like this to take into consideration. Which is a great point to raise up. I provide thoughts above as general inspiration but clearly you can find questions such as one you start up the place that the most crucial thing is going to be getting work done in honest very good faith. I don?t determine if guidelines have emerged around stuff like that, but I am certain that the job is clearly identified as a fair game. Both boys and girls have the impact of only a moment’s pleasure, through-out their lives.

  60. Exceptional content! I absolutely demonstrated a going through. I’m hoping to learn to read added away from you. There’s no doubt you’ll have beneficial awareness not to mention dream. My group is seriously pleased just for this important info.

  61. An intriguing discussion is worth comment. There’s no doubt that that you simply write much more about this topic, may possibly not become a taboo topic but

  62. Associations are typically powerful. Custom made is in fact extraordinarily vital, in addition to alter arrives rarely along with slowly. There’s pretty smaller division linked with job in to distinct responsibilities. As an alternative, every particular person is in fact very likely to execute a terrific number of duties, whilst duties differs somewhere between your genders.

  63. The vacation special deals offered are believed as a selection of possibly the most preferred and therefore within your budget all over the globe. Quite a number of hostels can be proudly located inside property which is accented who has striking seashores encouraging crystal-clear rivers, contingency of an Ocean. hotels compare rates

  64. The ideas you provided here’s extremely precious. It turned out a real pleasurable surprise to get that awaiting me while i woke up today. They may be constantly to the level and easy to be aware of. Thanks plenty for your valuable ideas you’ve got shared in this article.

  65. Will you mind if I cite a couple of your current posts providing that I provide acknowledgement combined with article sources back to your website? My blog site is within the similar niche as your site and my viewers will make use of some of the strategies your site offer here. Feel free to inform me if it is okay for you. Best wishes!

  66. Hello, i think that i noticed you visited my blog so i came to “go back the favor”.I’m trying to to find things to improve my web site!I suppose its good enough to make use of a few of your ideas!!

  67. It’s appropriate time to make some plans for the future and it is time to be happy. I have read this post and if I could I wish to suggest you few interesting things or advice. Perhaps you could write next articles referring to this article. I desire to read even more things about it!

  68. There a few intriguing points in time in this post but I don’t know if I see these people center to heart. You can find some validity but Let me take hold opinion until I investigate it further. Great write-up , thanks and now we want far more! Put into FeedBurner likewise

  69. That is a beneficial viewpoint, however isn’t make every sence whatsoever dealing with which mather. Any method thanks in addition to i had make an effort to share your current post straight into delicius but it surely is apparently an issue using your websites is it possible to you should recheck this. many thanks again.

  70. Great wordpress blog here.. It’s hard to find quality writing like yours these days. I really appreciate people like you! take care

  71. I thought it was going to be some boring old post, but it really compensated for my time. I will post a link to this page on my blog. I am sure my visitors will find that very useful.

  72. I have to get across my appreciation for your kindness giving support to people that actually need help with this concept. Your personal commitment to getting the solution across had become really effective and has continuously made some individuals like me to realize their desired goals. Your own insightful advice denotes this much to me and somewhat more to my office workers. Many thanks; from all of us.

  73. Can I just say what a relief to seek out someone who actually is aware of what theyre talking about on the internet. You undoubtedly know the way to bring an issue to light and make it important. More folks have to read this and understand this aspect of the story. I cant believe youre not more popular because you positively have the gift.

  74. Thank you for the good writeup. It in fact was a amusement account it. Look advanced to more added agreeable from you! By the way, how could we communicate?

  75. After study a few of the content with your website now, and i truly much like your way of blogging. I bookmarked it to my bookmark website list and will be checking back soon. Pls look into my internet site in addition and inform me what you think.

  76. I do not even know how I ended up here, but I thought this post was great. I don’t know who you are but definitely you’re going to a famous blogger if you aren’t already 😉 Cheers!

  77. Hey there this is somewhat of off topic but I was wanting to know if blogs use WYSIWYG editors or if you have to manually code with HTML. I’m starting a blog soon but have no coding knowledge so I wanted to get advice from someone with experience. Any help would be greatly appreciated!

  78. Just article, We liked its style and content. I discovered this blog on Yahoo and also have now additional it to my personal bookmarks. I’ll be certain to visit once again quickly.

  79. I’m often to blogging and i really appreciate your content. The article has actually peaks my interest. I’m going to bookmark your web site and maintain checking for brand spanking new information.

  80. As far as me being a member here, I wasn’t aware that I was a member for any days, actually. When the article was published I received a username and password, so that I could participate in Comments, That would explain me stumbuling upon this post. But we’re certainly all members in the world of ideas.

  81. There are some attention-grabbing closing dates in this article however I don know if I see all of them heart to heart. There may be some validity however I’ll take hold opinion until I look into it further. Good article , thanks and we wish extra! Added to FeedBurner as properly

  82. I am no longer sure the place you’re getting your info, but great topic. I needs to spend some time finding out more or working out more. Thanks for excellent information I was searching for this information for my mission.

  83. Amazing post – Gulvafslibning | Kurt Gulvmand however hey I having a issue we can not seem to be capable of sign up your rss feed, I am using bing reader fyi Thx ! Flash Factory

  84. Nice post. I learn one thing tougher on different blogs everyday. It should at all times be stimulating to learn content from different writers and observe slightly something from their store. I’d desire to use some with the content on my weblog whether you don’t mind. Natually I’ll give you a link in your web blog. Thanks for sharing.

  85. The the next occasion Someone said a weblog, I hope which it doesnt disappoint me around that one. Get real, Yes, it was my solution to read, but I just thought youd have something interesting to convey. All I hear is a bunch of whining about something you could fix when you werent too busy searching for attention.

  86. Youre so cool! I dont suppose Ive learn something like this before. So nice to find any individual with some authentic thoughts on this subject. realy thanks for beginning this up. this web site is one thing that is wanted on the internet, somebody with a bit originality. useful job for bringing something new to the internet!

  87. I’m often to blogging and i really appreciate your content. The article has actually peaks my interest. I’m going to bookmark your web site and maintain checking for brand spanking new information.

  88. I’m not sure exactly why but this weblog is loading incredibly slow for me. Is anyone else having this problem or is it a problem on my end? I’ll check back later and see if the problem still exists.

  89. No deposit bonuses can be used to play slots and other casino games for real money. The best part is you don’t have to deposit any money to the site to claim the bonus which means there is no risk involved. As long as you meet the terms and conditions attached to the bonus, any money you win is yours. Many casinos offer a variety of bonuses to get you started, such as free spins, cash bonuses, or even a no-deposit bonus. These bonuses can help you play longer and increase your chances of winning big. To help you find the best no deposit bonus offers and bonus codes, we have created this list of all available free casino bonuses we have been able to find on the internet. Use the list above to find the right offer for you or keep reading below to learn more about no deposit bonuses and promotions.
    https://www.parametriczoo.com/index.php/community/profile/3860cxliii5272i/
    Congratulations to Adriana–on June 4, 2023 this lucky guest hit the jackpot while playing the Triple Double Red, White & Blue slot game and won $3,000! Play Giant Fortunes Slot and Win Huge Prizes with 70 Free Spins Feeling lucky? Get ready to spin the reels on Giant Fortunes and earn yourself an astounding 70 free… WANT TO SEE MORE EXCITING WINS? wcybula -Thank you for the feedback and sorry for the confusion. We do offer World Class customer service to each of our guests, regardless of Card level, however, our diamond club members do get a few more perks. 🙂 All of our slots pay out according to industry standard and our slot house rules are posted at the Casino and online. See you again soon friend!-San Manuel Casino Choosing a casino for slots can feel like an impossible task when every place has flashy lights, energetic crowds, and the potential to win some cash. You need to visit these top casinos on the Strip and in downtown Las Vegas for the best slot experience!