Abstract
Milia are small sub epidermal keratin cysts. They may be seen following bullous diseases disrupting the dermo‐epidermal junction. They may occur rarely as a complication to contact allergic reactions. An oak moss allergic patient participated in a dose response ROAT with chloratranol, shown to be a potent allergen in oak moss. The patient reacted to choratranol at patch testing down to 0.0063 ppm, and started a ROAT by application of 2 drops of a 5 ppm solution to an area of 3 × 3 centimetres on the volar aspect of one forearm. After 1 day severe oedematous dermatitis was observed and blistering was seen at day 2. The test was stopped and the patient treated with systemic prednisolone. At a 3 month control visit milia were seen at the application site on the forearm but not on the back where the patch tests were applied. The patient had no subjective symptoms and the milia were easily removed with a sterile needle. The presence of milia as sequelae seems to reflect the depth and severity of the allergic contact dermatitis developed months earlier. This observation underlines the potency of chloratranol as a very strong allergen.
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