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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Lever’s Histopathology of the Skin. Lupus miliaris disseminatus faciei — The DNA of Mycobacterium tuberculosis miliars not detectable in active lesions by polymerase chain reaction. Lupus miliaris disseminatus faciei LMDF is an uncommon facial dermatosis.

Late stage granulomas contain scattered lymphocytes, histiocytes, and neutrophils amidst extensive perifollicular fibrosis with mild thinning of the epidermis [ 29 ].

Lupus miliaris disseminatus faciei

Overall, clinical response to all treatments has been poor. Lupus miliaris disseminatus faciei LMDF is a granulomatous eruption characterized by idsseminatus, reddish-brown papules and nodules predominantly localized on the face.

Multiple monomorphic papules over face Click here to view. Lupus miliaris disseminatus faciei; Caseation necrosis, Caseous necrosis; Lupus miliaris; Acne agminata; Follicle centered granuloma; Epithelioid granuloma. This highly variable clinical presentation demonstrates the diagnostic challenge concerning LMDF.


Open in a separate window. If the broader histopathologic definitions of LMDF were to be considered, distinguishing between these two entities would prove to be challenging. She denied taking oral steroids or applying topical steroids on the face at any time in the past.


May 19, ; Accepted date: Mliiaris nm diode laser has recently been shown to be effective in the treatment of active inflammatory acne lesions miliqris the back and face. The case series included 6 men and fsciei women from 6 to 79 years of age mean, Disruption of hair follicles in approximation to the granulomas was noted in two cases Figure 1B and Figure 2B. Lupus miliaris disseminatus faciei LMDFmorphea, tuberculosis.

Typical skin lesions of LMDF are multiple miliairs, smooth, mm, monomorphic, symmetrical reddish-brown or brown-to-yellowish dome-shaped translucent papules and nodules occurring on the chin, forehead, cheeks, and eyelids. 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.

The lesions initially appeared on the chin and left side of the neck, which progressively involved his forehead, both the cheeks, earlobes, upper eyelids, and whole of his neck over a period of 2 months. Author information Copyright and License information Disclaimer.

The upper dermis shows few epithelioid cell granulomas with the presence of giant cells, surrounded by chronic inflammatory cell infiltrate. Further information is needed to clarify the diagnosis, etiology, and pathogenesis of this disease, but an unusual host response to folliculitis or follicular injury likely plays a role in most cases.

Lupus miliaris disseminatus faciei is a rare inflammatory dermatosis of unknown etiology that primarily affects young adults.

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Lupus miliaris disseminatus faciei pathology

Get free access to newly published articles. A patient with lupus miliaris disseminatus faciei treated successfully with a combination of oral metronidazole and topical tacrolimus.


Some of the early lesions have demonstrated lymphocytes within follicular walls [ 29 ].

Eight of the lesions were described as papules, the other muliaris as nodules. Our patient could not tolerate tetracycline-class antibiotics, and her disease was resistant to treatment with several systemic agents, including erythromycin, isotretinoin, and prednisone. A variety of treatments including tetracyclines, dapsone, isotretinoin, tranilast, oral corticosteroids, and combination therapies have shown variable efficacy in LMDF [ 151011 ].

Others postulate an immune response to pilosebaceous units or a foreign body reaction to sebum, keratin, ,iliaris Demodex folliculorum from ruptured follicles [ 1349 ].

The presence of a predominately lymphocytic perifollicular infiltrate with invasion of the follicular wall in early lesions suggests the possibility of an attack on risseminatus 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. J Pak Assoc Derma ; Significant clinical improvements in skin lesions were noted 4 weeks after the first treatment. National Center for Biotechnology InformationU.

Report of a new case and brief literature review. Axillary acne agminata lupus miliaris disseminatus faciei. No foreign bodies were found in the granulomas, and no mycobacterial or fungal components were detected in dermal tissues by Ziehl-Neelsen staining or periodic acid-Schiff PAS staining.