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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A variety of treatments including tetracyclines, dapsone, isotretinoin, tranilast, oral corticosteroids, and combination therapies have shown variable efficacy in LMDF [ 151011 ]. Support Center Support Center. As the name implies, LMDF was once thought to be caused by Mycobacterium tuberculosis, but no organisms have been demonstrated and no culture or polymerase chain reaction PCR evidence of mycobacterial disease has been confirmed [ 16 ].
Support Center Support Center. No scarring or pigmentary alterations were associated with treatment. Do not submit color prints unless accompanied by original transparencies. 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. From January to Septemberthe records of 10 patients with a histopathologic diagnosis of lupus miliaris disseminatus faciei were collected from our dermatopathology archive.
Lupus miliaris disseminatus faciei
Br J Dermatol ; Overall, clinical response to all treatments has been poor. The records of 10 patients visseminatus age, A biopsy specimen revealed epithelioid cell granulomas with central necrosis, consistent with a diagnosis of lupus miliaris disseminatus faciei Figure 2. Fully developed lesions are further broken down into 4 groups based on the type of granulomatous reaction [ 1 – 49 ].
Clinically, this dermatosis appears as small, discrete, reddish-yellow or yellowish-brown asymptomatic papules involving primarily the central face, typically on and around the eyelids, although there are some reports of extrafacial involvement. Significant clinical improvements in skin lesions were noted 4 weeks after the first treatment.
There was no history of sexual promiscuity or any genital ulcer disxeminatus in the past. Multiple, small, reddish-brown papules scattered over the forehead, eyelids, nose, cheeks, perioral area, and chin.
May 19, ; Accepted date: Create a free personal account to download free article PDFs, sign up for alerts, and more. National Center for Biotechnology InformationU.
LUPUS MILIARIS DISSEMINATUS FACIEI WITH UNUSUAL DISTRIBUTION OF LESIONS
Dermatology Online J ; Now a days, it is considered to be a variant of rosacea. Faciej, it is characterized by an asymptomatic papular eruption mainly involving the central face, typically on and around the eyelids. Hyperkeratosis, dilatation of pilosebaceous units, follicular plugging, and pigment incontinence have been variably present [ 2 ].
Surrounding erythema is not a characteristic feature, but may be present. Report of a new case and brief literature review. Significant improvement of the lesions after 16 weeks of combined treatment with minocycline and prednisolone.
Some consider LMDF to fall on a spectrum between granulomatous rosacea and sarcoidosis [ 6 ]. There are a number of possible mechanisms by which the nm diode laser can improve lupus miliaris disseminatus faciei.
Nevertheless, an immune response to the pilosebaceous unit seems highly likely to be involved in the granuloma formation in many cases of LMDF [ 9 ]. Mycobacterial and fungal infections may be ruled out with special stains Ziehl Neelson and GMS respectively. Its pathogenesis may be related to that of LMDF, and it has a similar clinical presentation and disease progression – a wide distribution of papules to nodules that frequently undergo spontaneous resolution and may improve with the use of systemic corticosteroids [ 6 ].
Histopathological examination of a skin biopsy taken ulpus a representative lesion on the chin revealed dermal epithelioid cell granulomas, some with central areas of necrosis, and surrounding moderate lymphohistiocytic infiltrate with multinucleate giant cells, mostly of the Langhans type Figure 2.
Lupus Miliaris disseminatus faciei: Lesions of lupus miliaris disseminatus faciei before treatment A and after 3 treatments B with the nm diode laser. This left few, if any, established treatments for her condition, which remained active. A patient with lupus miliaris disseminatus faciei treated successfully with a combination of oral metronidazole and topical tacrolimus.
We present the case of miliaros 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. 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.
However, multiple extrafacial sites of involvement and one case without any facial involvement have been reported [ 167 ]. Lippincott Williams and Wilkins; Complete resolution of skin lesions was noted by the third treatment. Locations included the cheek, luppus lip, medial canthus, eyelid, temple, antihelix, neck, and lower back Table 1.
One case demonstrated a perifollicular lymphocytic infiltrate with minimal follicular invasion. Tuberculin test was negative.