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Lupus miliaris disseminatus faciei (LMDF) is a granulomatous eruption characterized by monomorphic, reddish-brown papules and nodules predominantly. A biopsy specimen revealed epithelioid cell granulomas with central necrosis, consistent with a diagnosis of lupus miliaris disseminatus faciei (Figure 2). Lupus miliaris disseminatus faciei (LMDF) first described in is an uncommon dermatosis of unknown etiology with characteristic.

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Lupus miliaris disseminatus faciei; Caseation necrosis, Caseous necrosis; Lupus miliaris; Acne agminata; Follicle centered granuloma; Epithelioid granuloma. Finding these changes in a biopsy obtained in the context of multiple lesions can be of considerable importance, since early lesions of LMDF which may show only nonspecific perivascular and perifollicular infiltrates comprised of lymphocytes, macrophages, and neutrophils may be amenable to treatment and the prevention of scar formation [ 1 ].

There are a number of possible mechanisms by which the nm diode laser can dsiseminatus lupus miliaris disseminatus faciei. The clinical diagnosis or differential diagnosis at time of biopsy included basal cell carcinoma BCC in six cases and sarcoidosis, granuloma annulare GAand epidermal cyst in two cases each.


Sarcoidosis is also considered in the differential diagnosis of LMDF. Treatment is difficult and there is a lack of controlled studies. Biopsy from a representative skin nodule showed mild epidermal hyperplasia and granulomatous reaction pattern in the dermis. The presence of a predominately lymphocytic perifollicular infiltrate with invasion of the follicular wall in early lesions suggests the possibility of an attack on hair follicles by lymphocytes as the initial triggering event that leads to damage of the follicular wall and eventual release of potential antigens into the dermis.


Locations included the cheek, cutaneous lip, medial canthus, eyelid, temple, antihelix, neck, and lower back Table 1.

The detection of Propionibacterium acnes signatures in granulomas of lupus miliaris disseminatus faciei.

A Review of Lupus Miliaris Disseminatus Faciei-Like Histopathologic Changes in 10 Cases

Lupus miliaris disseminatus faciei LMDFmorphea, tuberculosis. We suggest that the presence of epitheloid granulomas with central caseation in these cases warrants consideration that these entities may actually represent part of the spectrum of disease of LMDF. Sitemap What’s New Feedback Disclaimer. Dermatol Online J ; Lupus miliaris disseminatus faciei- pathologic study of early, fully developed, and late lesions.

J Clin Exp Dermatol Res 5: Guidelines Upcoming Special Issues. Author information Copyright and License information Disclaimer. Lupus miliaris disseminatus faciei has a spontaneously resolving course, yet can be cosmetically debilitating given the location and potential for scarring.

Microscopic findings are essential for diagnosis and characteristically reveal superficial granulomatous inflammation surrounding caseation necrosis that is often perifollicular in distribution, although LMDF is now regarded as a spectrum classified into three histological stages: Please review our dissemlnatus policy.

LMDF has been considered to be a form of granulomatous rosacea, supported by the frequent close association with pilosebaceous units [ 117 ].

Red papules on the face with secondary scarring. Our patient had extensive involvement of the face, with unusual involvement of the ear lobes, neck, and the shoulder girdle. The granulomas were located in the upper dermis in six cases and in the mid dermis in two cases.


Overall, clinical response to all treatments has been poor. Muller J Med Sci Res ;8: Studies revealing ffaciei lysozyme reaction in LMDF suggest that an infectious agent may induce cell-mediated immunity, with subsequent formation of epithelioid cell granulomas [ 12 ]. One case report described LMDF without any facial involvement; the papules were located on the neck and chest only [ 7 ]. Is ‘lupus miliaris disseminatus faciei’ still disseminatu acceptable diagnosis in the third millennium?


Eight disseminatsu the lesions were described as papules, the other two as nodules. LMDF is an uncommon dermatosis, with about cases reported to cisseminatus. A distinctive rosacea-like syndrome and not a granulomatous form of rosacea.

Clinically, it is characterized by an asymptomatic papular eruption mainly involving the central face, typically on and around the eyelids. Self-skin examination New smartphone apps to check your skin Learn more Sponsored content.

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Lupus miliaris disseminatus faciei

He was put on minocycline mg daily and is under follow up. Is miliafis a variant of lupus miliaris disseminatus faciei? Home Publications Conferences Register Contact.

Surrounding erythema is not a characteristic feature, but may be present. Br J Dermatol ; Flattening of the papules was observed within 3 weeks of therapy. Lupus miliaris disseminatus faciei is a rare dermatologic disease that is characterized clinically by the presence of discrete, red-brown, dome-shaped papules on the face that resolve with pitted scars.