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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Our website uses cookies to enhance your experience. Lupus miliaris disseminatus faciei. 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.

As the name implies, LMDF was once thought to be caused by Mycobacterium tuberculosis, dissemimatus no organisms have been demonstrated and no culture or polymerase chain reaction PCR evidence of mycobacterial disease has been confirmed [ 16 ].

Surrounding erythema is not a characteristic feature, but may be present. Patterson 23. It responds poorly to treatment with oral tetracycline-class antibiotics and oral isotretinoin, which are considered the mainstay of treatment. Lupus miliaris disseminatus faciei, Part II: PCR and culture studies may be used if an infection is suspected.

J Am Acad Dermatol. Fully developed lesions are further broken down into 4 groups based on the type of granulomatous reaction [ 1 – 49 ]. Report of two cases.

In the 3 cases with multiple lesions, a typical distribution was found on the central to lateral face with a predilection for the periorbital areas. J Clin Exp Dermatol Res 5: May 19, ; Accepted date: Sitemap What’s New Feedback Disclaimer. Friedman, MD ; Sharon R. Treatment is difficult and there is a lack of controlled studies.


Axillary acne agminata lupus miliaris disseminatus faciei. One patient was symptomatic with complaints of mild tenderness over the lesion. No recurrence was noted over a month observation period. The following report describes the clinical and histopathologic findings in 10 cases of LMDF seen in our institution over a year period.

Hymes, MD ; Leonard H. A clinical and histologic study of granulomatous rosacea. Additionally, sarcoidosis can be distinguished by physical examination, chest X-ray, and laboratory tests, and infectious disorders by the absence of microorganisms detected through histochemical stains PAS, Ziehl-Neelsen. Clinical features reviewed included age of patient, location and number of lesions, duration, description dissmeinatus primary lesion, size, and suspected clinical diagnosis or differential diagnosis.

To determine the clinical and histopathologic features miliarie all lesions diagnosed as lupus miliaris disseminatus faciei via disseminatue over the past 16 years at a single institution. One case demonstrated a perifollicular lymphocytic infiltrate with minimal follicular invasion.

Puppin D Jr, Gueissaz F. The lesions were initially treated with topical metronidazole cream, without improvement. Small pustules may rarely accompany the papules [ 36 ]. Rocas D, Kanitakis J. Lupus miliaris disseminatus faciei LMDF is a granulomatous eruption characterized by monomorphic, reddish-brown papules and nodules predominantly localized on the face. Privacy Policy Terms of Use. Age y Sex Site Lesion No. 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.


Therefore, we advocate focusing disseminatks histologic diagnostic criteria on fully developed lesions demonstrating classic epithelioid granulomas with central caseation necrosis.

Lupus miliaris disseminatus faciei pathology | DermNet NZ

Lupus miliaris disseminatus faciei; Caseation necrosis, Caseous necrosis; Lupus miliaris; Acne agminata; Follicle centered granuloma; Epithelioid granuloma.

B, Resolution of papules after 3 treatments with the laser. A final diagnosis of lupus miliaris disseminatus faciei was made based on the above-mentioned features. We present the case of a 30 year old patient with characteristic complaints of eruption of multiple, discrete reddish raised asymptomatic lesion all over face with histopathology suggestive of Lupus miliaris disseminatus faciei. However, some authors have proposed that there is a histopathologic spectrum of lesions that can be divided into three stages: Extrafacial involvement in LMDF has been rarely reported in the literature.

Lupus miliaris disseminatus faciei pathology

LMDF has been considered to be a form of granulomatous rosacea, supported by the frequent close association with pilosebaceous units [ 117 ]. Lymphocytes were seen in eight cases Figure ; the lymphocytes formed an outer layer surrounding the granuloma in four cases Figure 3. While this finding could represent a non-immunological foreign body granuloma reaction, the presence of moderate to intense staining of lysozyme in the epithelioid histiocytes and multinucleate giant cells of LMDF suggests a role for cell-mediated immunity.