In this article we describe a clinical entity appearing in seven preadolescent patients who presented with chronic red papules within a prominent nasal crease. Milia were also noted in the nasal crease, but there was no evidence of acne vulgaris. The duration of symptoms was 4 months to 2 years, and lesions ranged from inflamed red papules, which were treated with topical antiinflammatory medications, to scarred white papules requiring excision. Histologic evaluation of two lesions revealed keratin granulomas that were likely derived from ruptured, inflamed milia. Due to its similarity in appearance to acne vulgaris, but different pathogenesis and clinical course, we suggest naming this newly described entity "pseudoacne of the nasal crease."