Transverse nasal crease and transverse nasal milia: clinical variants of the same entity.

BACKGROUND Transverse nasal crease is an uncommonly reported entity. It likely represents an embryologic fault line. Transverse nasal milia have also been reported in the same location, both as an isolated finding and in a transverse nasal crease. This observation suggests they are variants of the same entity. OBSERVATIONS Two cases, one of transverse nasal crease with milia and one of transverse nasal milia in the absence of a crease, are reported. A review of the literature on these rarely reported conditions was performed. CONCLUSIONS It is important for clinicians to be aware of transverse nasal creases, since they may be encountered in a dermatologic practice. Transverse nasal creases, milia in transverse nasal creases, transverse nasal milia, and transverse nasal comedones in the absence of a transverse nasal crease are likely variants of the same entity. They most probably occur because the triangular cartilage and the alar cartilage attach in a linear fashion at the junction of the middle and lower third of the nose. This produces a potential embryonic fault line in which retention cysts presenting as milia and comedones can occur. These clinical presentations merit attention because they are likely much more common than reported.