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White papules around the ears: a quiz. Milia en plaque.

A 67-year-old patient presented multiple grouped and disseminated small whitish cystic papules, varying in diameter between 0.5 and 3 mm. They occurred first on both eyelids, followed by the neck and anterior neckline and, finally, on both ears over a period of 7 years. On both ears they appeared on a yellowish-brown plaque, mimicking a nevus sebaceous, at the periand intra-auricular areas, including the crus of helix and the complete concha (Fig. 1). The patient complained of painful ears and a burning sensation. Apart from a slight increase in total cholesterol and lowdensity lipoprotein (LDL)-cholesterol levels, paraclinical tests were normal. There was no history of trauma, blistering disease or systemic medication, and no relatives known to have similar skin lesions. The patient denied using cosmetic creams or oils. The patient did not wear glasses but did wear earrings; however, the ear lobes were not affected. The auricular skin lesions were treated unsuccessfully with clobetasol solution.