An unmarried white woman aged 53 requested the removal of a number of milia and milium-like lesions of the face. The lesions occurred singly, on the lower half of the center of the forehead, on the cheeks, the nose and the sides of the chin. Some of them appeared to be slightly elevated, pinhead-sized to match-head-sized, nonpigmented moles, but they were hard to the touch. A grating sensation was experienced when the pointed bistoury was used to incise the skin as a preliminary step in the removal of the content of the lesions, which "popped out" in one piece. The largest of about a dozen lesions was half lentil sized, stony hard and shaped like a miniature cauliflower. The milia were of varying degrees of hardness, from what would be expected to a degree approaching the aforementioned description. This gave the impression that the lesions showing metaplasia of bone began as milia.
COSTELLO MJ. METAPLASIA OF BONE: Report of a Case. Arch Derm Syphilol. 1947;56(4):536–537. doi:10.1001/archderm.1947.01520100132021
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