Milia en Plaque After Pickleball Injury: A 57-year-old woman developed a rare skin condition called milia en plaque (MEP) weeks after being struck on the cheek by a pickleball while playing the sport. The lesion appeared on her right cheek in the United States, drawing attention to a unique case of sports-related skin trauma.
An Unusual Result of a Common Injury
The woman had no previous skin issues in that area. After being hit by a pickleball, a small blister formed with minor bleeding. She applied a topical antibiotic with neomycin, polymyxin B, and bacitracin. The wound did not hurt or itch, but it did not heal normally.
Three to four weeks later, the area became thick and firm. She visited a dermatologist and was examined for the unusual lesion. A tan plaque, about 2 cm by 1.5 cm, with small white cysts was noted. A biopsy was performed to confirm the diagnosis.
What Doctors Found
Histopathologic testing revealed squamous epithelium with an intact granular layer and one cyst containing a hair shaft. These signs led doctors to diagnose the lesion as milia en plaque (MEP), a rare condition usually caused by trauma to the skin.
MEP causes small white cysts to appear on red, thickened patches of skin. It is not usually caused by sports injuries. In this case, the trauma from a pickleball impact appears to have triggered the condition by damaging the skin’s surface.
Sports Injuries and Skin Trauma
Pickleball is the fastest-growing sport in the U.S., known for being low impact and easy to learn. As more people play, injuries are becoming more common. Reports often mention sprains, fractures, and back pain—but not skin conditions.
Most skin injuries in paddle or racket sports are caused by balls, paddles, or the court surface. These usually result in cuts, bruises, or scrapes. However, this case shows that even a minor impact can lead to more unusual outcomes.
Treatment Options Discussed
Because the lesion had several cysts and was located on the cheek, dermatologists presented the case at a department-wide meeting. Usual treatments for MEP include watching the spot or removing the cysts.
Removing multiple cysts at once could be painful and leave scars. Doctors suggested removing them in stages, after the patient used tretinoin 0.1% cream for 3 to 4 months. Other options included continuing tretinoin, using laser treatment, or doing nothing. The patient decided to try tretinoin and will return in a few months for follow-up care.
Why This Case Matters
Until now, there have been no reports of milia en plaque developing from pickleball or other sports. This case shows that sports injuries can lead to rare skin conditions. It also raises awareness about how sports-related trauma can affect the skin, not just the bones or muscles. Doctors hope this case will help others recognize skin problems caused by sports, especially as more people take up pickleball.
News in Brief: Milia en Plaque After Pickleball Injury
A 57-year-old woman developed milia en plaque after being hit by a pickleball on the cheek. This rare skin condition, linked to trauma, was diagnosed weeks later. Her case highlights a new type of sports injury and expands awareness of skin issues that can result from playing pickleball.
ALSO READ: From Hip Injury to Global Inspiration: How Miranda Cabieses is Changing Lives Through Pickleball