Does the Rosacea-like Tuberculid Exist?

Michelson, Henry E.

doi:10.1001/archderm.1958.01560120001001

Cited by 8 publications

(7 citation statements)

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“…Ueki and his co-worker (8) reported that granulomas in the lesions of LMDF might be evoked by a kind of foreign-body reaction to the sebum. Michelson (27) reported that it was natural for histologic reactions to destroyed sebaceous cells to resemble epithelioid cell granulomas. Strauss and Pochi (28) reported that they were successful in making experimental epithelioid cell granulomas, especially Lewandowsky type tubercles, by injecting sebum or comedones into the dermis.…”

Section: Commentmentioning

confidence: 99%

Clinicopathological and Immunological Studies of Lupus Miliaris Disseminatus Faciei

Shitara

1982

The Journal of Dermatology

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Eighty‐one cases of lupus miliaris disseminatus faciei were clinically and histologically studied, and some of them were also immunologically studied. Age at onset, distribution of skin lesions, and incidence by sex did not differ from the reports of various investigators. No apparent increase in incidence of this disease was noted. The histologic features of this disease could be divided into four types. Some relation between pilosebaceous units and epithelioid cell granulomas could be found in the lesions of 35 (43%) out of 81 cases. Central caseation may be coagulation necrosis caused by abscesses. Some immunological data were obtained from this study, but there were no abnormalities in delayed hypersensitivity reactions, e.g. tuberculin test, DNCB skin reaction, PHA skin reaction and the Kveim test, or in quantitative serum immunoglobulin surveys. Lymphocyte transformation tests using two mitogens, PHA‐P and Con‐A, showed normal responses. It was not possible to obtain enough data from the clinical data and histologic findings for this disease to be regarded as a tuberculid. But from the histologic findings, lupus miliaris disseminatus faciei was assumed to be a chronic inflammatory disease of pilosebaceous units and epithelioid cell granulomas in the lesions might be reactions to destroyed hair follicles or epithelial cysts. With these assumptions, the following hypotheses concerning the pathogenesis of this disease were proposed. 1) Epithelial cysts occur and rupture in the dermis for some reason resulting in formation of foreign‐body granulomas which break down epithelial cysts in the dermis. 2) Inflammatory infiltrates occur within the follicular epithelium or sebaceous glands for some reason and they are destroyed resulting in formation of epithelioid cell granulomas to follicular contents, such as keratin, sebum and Demodex folliculorum. Under the above assumptions, I would like to support the theory that lupus miliaris disseminatus faciei is not a tuberculid but a skin disorder similar to the papular type of acne rosacea.

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Section: Commentmentioning

confidence: 99%

Clinicopathological and Immunological Studies of Lupus Miliaris Disseminatus Faciei

Shitara

1982

The Journal of Dermatology

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“…Initially, it was considered a variant of lupus vulgaris or a tuberculid lesion, since the histological characteristics showed a granulomatous inflammatory infiltrate with caseous necrosis [6]. However, there has been no evidence to date that supports the link with tuberculosis.…”

Section: Commentarymentioning

confidence: 99%

“…I should mention that if some type of acne could be confused, especially in the initial stages, it will be with the steroid-type medication acne, due to its relation with monomorphic lesions. The acronym proposed in recent years of "FIGURE" (facial idiopathic granuloma with regressive evolution) is the most appropriate, since in addition to avoiding the link connection with acne or tuberculosis that defines the clinical, etiological and evolutionary aspects of this controversial and uncommon pathology [6]. Although the term "disseminated lupus miliary of the face" is the most well-known and widespread, it should begin to be reconsidered and changed.…”

Section: Commentarymentioning

confidence: 99%

“…Although the term "disseminated lupus miliary of the face" is the most well-known and widespread, it should begin to be reconsidered and changed. A short time ago this pathology was conceived as a granulomatous or lupoid rosacea because relationship of granulomas with the pilosebaceous units because it common found epithelial granulomas in patient with rosacea 6 , however, the clinical characteristics are different, the disseminated lupus miliary of the face does not show a hyperreactivity of the facial vasculature, no erythema, and it does not worsen with caloric, solar, alcohol or spicy food stimuli and no telangiectases [14][15][16]. Many authors have also related this dermatosis with sarcoidosis in special with the maculopapular presentation, but the absence of systemic compromise, normal angiotensin-converting enzyme levels, lack of compromising of old scars, and finally the autoimmune behavior with punctate residual scar of the facial idiopathic granuloma with regressive evolution discard their linkage.…”

Section: Commentarymentioning

confidence: 99%

“…It has received different names over time: micro-apical tuberculids [1][2][3][4], acne agminata [5][6][7], rosacea lupoid [6,[8][9][10], names that has been related with these conditions, and with the passage of time, it has been losing its livelihood of association. After several clinical, histopathological and evolutionary observations, several authors have proposed the name of the Anglo-Saxon acronym FIGURE (facial idiopathic granulomas with regressive evolution), which in Spanish would be: idiopathic facial granulomas with regressive evolution [1,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Facial Idiopathic Granulomas with Regressive Evolution, is Lupus Miliar Diseminatus Faciae a Synonymous?

Eg¹

2017

CDOAJ

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Disseminated lupus miliary of the face (DLMF) has been reported infrequently at the time that has received multiple denominations. It is clinically characterized by brown erythematous monomorphic papules of between 1 to 4 millimeters in diameter and icepick scars like acne.The cases presented in this document show the variability of presentation and manifestation of this pathology, the same that in certain occasions coincides with the previous reports, but also exist in others pathologists with a different presentation.Treatment with corticosteroids has shown improvement in lesions, coinciding with the reported literature.

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