Volume 3, Issue 2, Pages (March 2017)

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Volume 3, Issue 2, Pages 106-109 (March 2017) Bilateral malar milia en plaque as primary presentation of discoid lupus erythematosus Johann de Wet, MBChB, MMed, H. Francois Jordaan, MBChB, MMed, M.Akad.SA, Willem I. Visser, MBChB, MFamMed, MMed JAAD Case Reports Volume 3, Issue 2, Pages 106-109 (March 2017) DOI: 10.1016/j.jdcr.2017.01.010 Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Multiple yellowish cysts on an erythematous plaque and scattered open comedones in a malar distribution. JAAD Case Reports 2017 3, 106-109DOI: (10.1016/j.jdcr.2017.01.010) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Dermoscopy found multiple milia cysts, follicular keratotic plugs, perifollicular whitish halos, pigmentation, and telangiectasia. JAAD Case Reports 2017 3, 106-109DOI: (10.1016/j.jdcr.2017.01.010) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 A, Histology showed a superficial and deep perivascular and periadnexal infiltrate consisting of lymphocytes. Numerous keratin-containing milia within the upper dermis (arrow). The epidermis showed dilated hair follicle infundibulae with keratin plugs and focal epidermal atrophy. B, A lichenoid infiltrate of lymphocytes surrounding a fragment of follicular epithelium with vacuolar degeneration (arrow). C, Mild increased dermal mucin (arrow). (A and B, Hematoxylin-eosin stain; C, alcian blue periodic acid–Schiff stain; original magnifications: A, ×4; B and C, ×10.) JAAD Case Reports 2017 3, 106-109DOI: (10.1016/j.jdcr.2017.01.010) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 After 6 weeks of treatment with topical tretinoin 0.1% cream and topical methylprednisolone 0.1% ointment. A decrease in the number of milia cysts and erythema can be seen. JAAD Case Reports 2017 3, 106-109DOI: (10.1016/j.jdcr.2017.01.010) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions