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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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Formalin-fixed, paraffin-embedded specimens were examined by hematoxylin-eosin staining. One patient was symptomatic with complaints of mild tenderness over the lesion. The etiology and pathogenesis of LMDF are unknown. Received Mar 10; Accepted Apr How to cite this article: A year-old white woman presented with a 3-year history of brown-red papules on her forehead, cheeks, nose, and chin Figure 1.

Some of the early lesions have demonstrated lymphocytes within follicular walls [ 29 ]. Clinical features reviewed included age of patient, location and number of lesions, duration, description of primary eisseminatus, size, and suspected clinical diagnosis or differential diagnosis. Multiple monomorphic papules over face Click here to view. We hereby report a case of LMDF with typical morphology of the lesions with extensive facial lesions and extrafacial localization.

In the fully developed stage, the following spectrum of changes can be seen: Although its pathogenesis and nature are not completely understood, lupus miliaris disseminatus faciei shares several common features with faciie acne vulgaris and rosacea.

Lupus miliaris disseminatus faciei pathology

May 19, ; Accepted date: Please review our privacy policy. Oral minocycline therapy mg twice a day was initiated but was discontinued shortly thereafter because of drug-induced urticaria. The nm diode laser has recently been shown to be effective in the treatment of active inflammatory acne lesions on the back and face. Treatment of LMDF is usually unsatisfactory, and there is lack of controlled studies in the literature. The nm diode laser would presumably also be effective in the treatment of the inflammatory and soft tissue forms of rosacea by targeting hair follicles and sebaceous glands and by reducing associated inflammation and fibrosis.

Lupus miliaris disseminatus faciei

Purchase access Subscribe now. The 10 cases we report demonstrate the importance of recognizing the entity in solitary as well as extrafacial forms.


In dissminatus, the variations in clinical and histologic presentation and the dissimilarities in response to therapy suggest the possibility that more than one mechanism may play a role in producing the lesions of LMDF [ 13 ]. Granulomatous rosacea, mucinosis, intradermal nevus, actinic keratosis, and deep molluscum were listed as clinical differential diagnoses in one case each Table 1.


It mainly affecting the central area of the face showing a characteristic tendency to involve the lower eyelids. Create a personal account to disseminayus for email alerts with links to free full-text articles. A variety of treatments including tetracyclines, dapsone, isotretinoin, tranilast, oral disseminahus, and combination therapies have shown variable efficacy in LMDF [ 151011 ].

The case series included 6 men and 4 women from 6 to 79 years of age mean, These findings further support the need to consider the diagnosis of LMDF for both solitary and extrafacial lesions demonstrating epithelioid granulomas with caseation necrosis, especially when follicular destruction is present.


LMDF most commonly affects young dissemiinatus of both sexes although cases among children and the elderly have been reported [ 58 ]. One case demonstrated a perifollicular lymphocytic infiltrate with minimal follicular invasion. Complete resolution of skin lesions was noted by the dissrminatus treatment. Venereal disease research laboratory VDRL test disseminatue non-reactive. 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 LMDF is an uncommon but mjliaris, chronic, inflammatory dermatosis characterized by abrupt development of generally asymptomatic, single to multiple, mm brown-red, brown, to yellowish dome-shaped papules or nodules with occasional mild scaling [ 1 – 5 ].

Lupus miliaris disseminatus faciei is a rare inflammatory dermatosis of unknown etiology that primarily affects young adults. Histopathologic features disseminafus included presence of caseation necrosis, depth of granuloma, presence of lymphocytic infiltrate, disruption of hair follicles, and presence of multinucleated giant cells. Sir, Lupus miliaris disseminatus faciei LMDF is a granulomatous eruption characterized by llupus, reddish-brown papules and nodules predominantly localized on the face.

Lupus miliaris disseminatus faciei. Author information Article notes Copyright and License information Disclaimer. Lupus miliaris disseminatus faciei LMDFmorphea, tuberculosis. In our report of 10 patients, the presence of an epithelioid granuloma with central caseation necrosis or necrobiosis was the requirement for histologic diagnosis. Our website uses cookies to enhance your experience.


The caseation observed in LMDF is thought to be a form of coagulation necrosis caused by abscesses rather than the caseation associated with Mycobacterium tuberculosis [ 4 ]. Late stage granulomas contain scattered lymphocytes, histiocytes, and neutrophils amidst extensive perifollicular fibrosis with luus thinning of the epidermis [ 29 ]. Support Center Support Center. Histopathological examination of a skin biopsy taken from 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.

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 ].

The granulomas typically arise adjacent to adnexal structures. Lupus miliaris disseminatus faciei has a spontaneously resolving course, yet can be cosmetically debilitating given the location and potential for scarring.

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Self-skin examination New smartphone apps to check your skin Learn more Sponsored content. However, LMDF is often clinically distinct from rosacea, since LMDF is self-limited with spontaneous resolution over years usually between monthsoften miliarsi disfiguring scars, does not present with erythema, flushing, or telangiectasia, is not exacerbated ,iliaris heat or spicy foods, and is often improved with oral corticosteroid treatment [ 135 ].

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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 faaciei