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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Treatment of LMDF is usually unsatisfactory, and there is lack of controlled studies in the literature. The granulomas typically arise adjacent to adnexal structures. The etiology of this condition is unclear. 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. Some of the early lesions have demonstrated lymphocytes within follicular walls [ 29 ].

Lupus miliaris disseminatus faciei pathology

Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. One patient had a history of similar lesions previously diagnosed as rosacea, and two other patients had a history of facial lesions diagnosed as cystic acne. A year-old white woman presented with a 3-year history of brown-red papules on her forehead, cheeks, nose, and chin Figure 1.

Histopathologically, there were epithelioid sarcoidal granulomas with central areas of necrobiosis or caseation necrosis in all specimens Figure 1.

J Am Acad Dermatol. Venereal disease research laboratory VDRL test was non-reactive. The clinical differential diagnosis in the classical presentation is broad and includes granulomatous rosacea, perioral dermatitis, small-nodular sarcoidosis, corticosteroid dermatitis resembling rosacea, acne vulgaris, polymorphic light eruption, eruptive syringomas, and multiple trichoepitheliomas [ 12 ].


Another proposal is that LMDF may be a reaction to an as-yet unknown infectious agent associated with cell-mediated immunity [ 12 ]. Author information Oupus notes Copyright and License information Disclaimer.

The etiology and pathogenesis of LMDF are unknown.

,iliaris free access to newly published articles. Each stage has distinct histological findings. In the setting of solitary lesions, especially on the trunk and extremities, the finding of epithelioid granulomas with central caseation necrosis may be thought to represent a reaction to a ruptured follicle or folliculitis.

Studies revealing intense lysozyme reaction in LMDF suggest that an infectious agent may induce cell-mediated immunity, with subsequent formation of epithelioid cell miliars [ 12 ]. To determine the clinical and histopathologic features of all lesions diagnosed as lupus miliaris disseminatus faciei via biopsy over the past 16 years at a single institution. LMDF typically occurs as symmetrically distributed eruptions in the center of the face.

Therefore, we advocate focusing the histologic diagnostic criteria on fully developed lesions demonstrating classic epithelioid granulomas with central caseation necrosis. May 19, ; Accepted date: Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more. Report of two cases. El Darouti M, Zaher H. Indian J Dermatol Venereol Leprol ; Please review our privacy policy.


Multiple, small, reddish-brown papules scattered over the forehead, eyelids, nose, cheeks, perioral area, and chin. Tuberculin test was negative. In summary, our study of these 10 cases expands upon what is known both clinically and histologically about lupus miliaris disseminatus faciei.


Research Article Open Access.

Purchase access Subscribe now. Extrafacial involvement in LMDF has faviei rarely reported in the literature. Characteristic histopathology includes a tubercle consisting of aggregates of epithelioid histiocytes and occasional multinucleate giant cells, which surround a usually large area of caseous necrosis.

Lupus miliaris disseminatus faciei pathology | DermNet NZ

Biopsy from a representative skin nodule showed mild epidermal hyperplasia and granulomatous reaction pattern in the dermis. Lupus miliaris disseminatus faciei is a rare inflammatory dermatosis of unknown etiology that primarily affects young adults.

If the diagnostic criteria were expanded to include the histologic presentation of early and late lesions as well as the other sub-classifications of fully developed lesions, the sample size would almost certainly have increased. Photomicrographs and illustrations must be clear and submitted as positive color transparencies mm slides or black-and-white prints. Lupus Miliaris disseminatus faciei: The records and archival slides were reviewed to determine the clinical appearance and distribution of skin lesions, their duration, and dermatologic history.