Milia en Plaque of the Eyelids in Childhood: Case Report and Review of the Literature

Abstract: Milia en plaque is a rare type of primary milia. Most of the reported cases have occurred around the ears in adults. We report milia en plaque in a 10-year-old girl who presented with symmetrical erythematous plaques studded with milia on the eyelids. Histopathology revealed milia surrounded by a dense lymphocytic infiltrate. Administration of minocycline and manual expression of the milia successfully treated this condition.     

Relapsing bullous amyloidosis of the oral mucosa and acquired cutis laxa in a patient with multiple myeloma: a rare triple association

It is well known that primary systemic amyloidosis [light chain (AL) amyloidosis] is associated with hidden dyscrasia or multiple myeloma. Acquired cutis laxa (cutis laxa acquisita; CLA) has also been described in patients with plasma cell dyscrasias, including multiple myeloma. We report a case in which haemorrhagic oral bullae were the first sign of an undiagnosed primary systemic amyloidosis related to multiple myeloma IgG‐λ and previously diagnosed CLA. There is only one report in literature of this rare triple association; however, in that case the patient did not have oral mucosal involvement or bullous amyloidosis.     

Milia En Plaque: Three New Pediatric Cases

Abstract: Milia en plaque (MEP) is an unusual and extremely rare clinical variant of milia, characterized by multiple milia‐like lesions overlying an erythematous edematous plaque with histologic findings consistent with milia. MEP tends to affect the middle‐aged patients and shows a predilection for women. Among children, this entity is rarely described and, to our knowledge, only four cases have been reported to date in the dermatologic literature. We add three new cases of children, one of whom had an unusual site of presentation.     

Light chain multiple myeloma with cutaneous AL amyloidosis

Cutaneous AL amyloidosis is one complication of multiple myeloma. In our patient, painful sclerotic skin changes on the extremities and macroglossia were the presenting features which led to a more detailed investigation and the diagnosis of multiple myeloma. Histological examination revealed cutaneous deposits of amyloid which were positive with Congo red stain and had an apple green color in polarized light.     

Nail abnormalities and scleroderma-like lesions on the face associated with systemic amyloidosis

INTRODUCTION: Mucocutaneous involvement in systemic amyloidosis occurs in 29 to 40 p. 100 of cases. Nail abnormalities are infrequent in AL amyloidosis. We report an original case of AL amyloidosis associated with cutaneous and integument alterations and scleroderma-like infiltration of the face. CASE REPORT: A 73 year-old woman was hospitalized because of weight loss and asthenia. She had been treated 4 years earlier with chemotherapy for a IgG-type multiple myeloma with complete resolution of the underlying monoclonal gammapathy. Cutaneous examination showed nail dystrophy of all fingernails associated with scleroderma-like skin changes on the chin and lips. Histopathologic study of a chin biopsy confirmed the presence of amyloid deposits in the dermis. Laboratory data were normal, without signs of recurrence of multiple myeloma. DISCUSSION: We report an original case of a patient who developed two unusual cutaneous manifestations associated with AL amyloidosis. Moreover, there was no correlation between the severity of the cutaneous lesions and the extent of the underlying hematological disease.     

儿童斑块型粟丘疹

报告2例有特殊临床表现的斑块型粟丘疹.2例患儿均为男性,年龄分别为12岁及13岁,表现为双侧耳郭及耳垂出现群集的小丘疹,部分融合成斑快,皮损在夏季反复出现,冬季自然消退.组织病理学检查显示真皮内表皮囊肿.文中对斑块型粟丘疹进行了文献复习,发现该2例患儿临床表现与文献报道的斑块型粟丘疹不完全一致,故认为是粟丘疹的一种新亚型.     

Retroauricular milia en plaque: a rare presentation of lupus erythematosus

Milia en plaque is a term used to describe an aggregation of milia occurring on an erythematous base usually localized in the retroauricular area. In most reported cases, no aetiological factors have been identified. We report the first case of milia en plaque associated with discoid lupus erythematosus occurring in the retroauricular site.     

Milia en plaque

Milia en plaque is a rare type of primary milia. Issues related to esthetics and differential diagnoses represent a concern to patients and a challenge for physicians. In this paper, a case of milia en plaque is reported and a review of the literature is described.     

Milia en plaque

Milia plaque is an unusual and rare variant of milia. We now report a Chinese man with numerous milia within an erythematous plaque of the upper and lower eyelids; histology confirmed the diagnosis and showed pericystic inflammation. All but one of the previous 10 reported cases affected the ear or adjacent sites, and to our knowledge, this is the first reported case of milia en plaque affecting the eyelids.     

Milia en plaque

Milia en plaque is a rarely reported entity which is usually appearing in the auricular region. We describe a well-defined, U-shaped milia en plaque arising in the infraorbital area, and emphasize that it should be considered in the differential diagnosis of xanthalesma.     

Quistes miliares en placa extrafacial

—Milia cysts are benign lesions secondary to local trauma. Primary milia may appear at birth, in adolescents and adults, affecting the eyelids, cheeks, forehead and genitalia. There are two special forms of primary milia in adolescents and adults, the eruptive form and the milia «en plaque ». Milia «en plaque» is a primary form consisting of slightly raised milia cysts grouped on an erythematous base. It occurs mostly in adult women, typically in the retroauricular region. Here we report a case of milia «en plaque» in a 9-yearold girl without previous injuries on the dorsum of the hand.     

Eyelid milia en plaque: a treatment challenge with a new CO2 fractional laser

Milia en plaque (MEP) is an uncommon finding characterized by numerous tiny milia within an erythematous area. Despite its benign and asymptomatic nature, MEP raises cosmetic concerns; moreover, the available treatment modalities for MEP are limited. In view of the few cases described in the literature, no consensus has been reached, with respect to the optimal treatment for MEP, and the choice of therapy should be individualized. We report a case of eyelid milia en plaque successfully treated with a new CO₂ fractional laser that is able to ensure superficial ablation of the epidermis remodeling tissue in‐depth, with minimal thermal damage and extremely rapid recovery time. The results obtained after only two treatments were good, no scarring or dyschromic changes have been registered. At 1 year, just few recurrent milia were present.     

Milia en plaque associated with pseudoxanthoma elasticum

We report a woman with numerous milia occurring in a plaque-type distribution in the postauricular area, who has suffered from cutaneous pseudoxanthoma elasticum on both sides of the neck. Milia may arise primarily or may follow a number of dermatoses. We believe this is a unique case because milia en plaque coexisting with pseudoxanthoma elasticum does not appear to have been reported previously.     

斑块型粟丘疹1例

患儿男,10岁。皮损特点为大量白色针头大小的丘疹,对称性散在分布于耳廓及耳垂内外侧,部分融合成斑块,无明显自觉症状,无外伤史及内服和外用药物史,无家族史。诊断:斑块型粟丘疹。     

Milia en plaque

Milia en plaque is an unusual presentation of milia. The exact pathomechanism and reason for postauricular localization is not yet understood. Faster resolution of lesions after usage of trichloracetic acid alongwith topical tretinoin was encouraging and may be used as adjunct in treatment of milia.     

Letter: Periorbital bilateral milia en plaque in a female teenager

We present the case of a 16-year-old girl with a 2-year history of progressive development of milia en plaque of the eyelids.     

Bilateral milia en plaque in a 6-year-old Chinese boy

Milia en plaque is a rare variant of miliathat occurs spontaneously on an erythematous base without identifiable causative factors. Approximately 40 cases have been recorded in the literature. Most occurred in the periauricular area, affected middle-aged patients, and showed a predilection for women. Here, we report a case of milia en plaque on the bilateral posterior helices in a 6-year-old Chinese boy.     

斑块状粟丘疹

报告4例斑块状粟丘疹。患者均为男性少年，平均年龄12岁。皮损特点是在红色斑块的基础上有大量谷粒至绿豆大白色丘疹，对称性散在分布于耳轮、对耳轮及耳垂，其间夹杂黑头粉刺。无明显自觉症状，发病前均有“冻疮”史。无内服及局部外用药物史，无家族史。组织病理检查示真皮内囊肿，囊壁由数层鳞状上皮细胞组成，囊肿内充满角质。局部皮损挑除及混合外用维A酸、糖皮质激素和多磺酸黏多糖，疗效满意。4例患儿的临床表现和组织病理改变与文献报道相符。     

Primary cutaneous nodular amyloidosis associated with psoriasis

Primary cutaneous nodular amyloidosis (PCNA) presents as solitary or multiple firm, waxy nodules with a predilection for acral areas. Histologically, PCNA can be identical to myeloma‐associated systemic amyloidosis with monoclonal immunoglobulin light chain deposits. We describe a patient in whom PCNA developed in a scar in an area affected by chronic plaque psoriasis. PCNA has previously been associated with other autoimmune diseases, but to our knowledge, this is the first association with psoriasis. Interestingly, T helper (Th)17 cells, which are crucial in psoriasis pathogenesis, have recently been implicated in promotion of myeloma and plasma cell dyscrasias. The association of psoriasis and plasma‐cell light chain production in the skin, as in this case, suggests a possible role for Th17 cells in PCNA formation. The dermatopathological literature of this rare but important disease is discussed.     

Primary Localized Amyloidosis in One Family

Primary localized amyloidosis was found in a family. A 66-year-old woman had suffered from hoarseness for 18 years. A biopsy specimen from the larynx showed amyloid deposits in the submucosal connective tissue. Her 40-year-old daughter noticed a subcutaneous nodule on her philtrum. Histologic examination showed the deposition of amyloid in the middle and lower dermis, which also encased the blood vessels and epidermal appendages. In both cases the amyloid deposits were positively stained with Congo red and the staining was resistant to potassium permanganate treatment. These amyloid deposits were strongly positive against the anti-amyloid antibody of the lambda light chain. These results indicate that the amyloid substance is derived from protein AL. There was no clinical or laboratory evidence of systemic amyloidosis or multiple myeloma in either patient.