Lupus miliaris disseminatus faciei: a case report.
A 33-year-old man presented to our clinic with asymptomatic red-brown, dome-shaped papules, distributed bilaterally on the central area of the face (forehead, lower portions of the eyelids, nasolabial folds, and perioral areas) these had evolved over a period of about 1 year. A skin biopsy, taken from a lesion on the forehead, revealed an epithelioid cell granuloma with central necrosis and surrounding lymphocytic infiltrate with multinucleate giant cells. The chest X-ray and the results of the laboratory studies were within normal limits; the Mantoux test was negative. The patient was treated with minocycline 100 mg/day for 4 months. There was significant clinical improvement, but papular lesions remained on the forehead. Later on, treatment with systemic steroids for 7 months resulted in the resolution of most lesions.


CONCLUSIONS
Lupus miliaris disseminatus faciei (LMDF) is an uncommon, chronic, inflammatory dermatosis characterized by red-to-yellow or yellow-brown papules of the central face, particularly on and around the eyelids. Originally, LMDF was considered to be a variant of lupus vulgaris or a tuberculid because of the histology, but there has been no evidence to date supporting a link to tuberculosis. Some authors consider LMDF to be a granulomatous forms of rosacea. However, our case supports the concept that it is a distinct entity.
Esteves
Tiago
T
Department of Dermatology, Hospital Central do Funchal, Funchal, Madeira, Portugal. tiago.castroesteves@gmail.com
Faria
Anabela
A
Alves
Rubina
R
Marote
Jorge
J
Viana
Isabel
I
Vale
Esmeralda
E
D000328:Adult; D003937:Diagnosis, Differential; D005148:Facial Dermatoses / Q000473:pathology*; D006099:Granuloma / Q000473:pathology; D006801:Humans; D008177:Lupus Vulgaris / Q000473:pathology; D008297:Male; D012393:Rosacea / Q000473:pathology; D012867:Skin / Q000473:pathology