Lupus miliaris disseminatus faciei: A Distinctive Rosacea-Like Syndrome and Not a Granulomatous Form of Rosacea

Scheur, Martijn R. van de; Waal, R.I.F. van der; Starink, Th. M.

doi:10.1159/000068457

Cited by 66 publications

(67 citation statements)

References 10 publications

(12 reference statements)

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“…Se caracteriza clínicamente por una erupción de pápulas monomórficas, eritematosas y parduzcas de entre 1 y 4 mm de diámetro, que pueden evolucionar a pústulas, principalmente localizadas en la parte central de la cara, con frecuente compromiso del área palpebral [6]. Se produce una autoinvolución de las mismas que se curan dejando cicatrices hiperpigmentadas en pica -hielo similares al del acné.…”

Section: Introductionunclassified

Estudio Descriptivo: Granulomas Faciales Idiopáticos con Evolución Regresiva, ¿Es el Lupus Miliar Diseminado Facial un Sinónimo?

Aldás¹,

Donoso

Garzón³

et al. 2017

Rev. Méd. HJCA

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Garzón E, et al.; Licencia Rev Med HJCA. Este es un artículo de acceso abierto distribuido bajo los términos de "CreativeCommonsAttribution-NonCommercial-ShareAlike 4.0 International License" (http://creativecommons. org/licenses/by-nc-sa/4.0/), la cual permite copiar y redistribuir el material en cualquier medio o formato; mezclar, transformar y crear a partir del material, dando el crédito adecuado al propietario del trabajo original.El dominio público de transferencia de propiedad (http://creativecommons.org/publicdomain/zero/1.0/) aplica a los datos recolectados y disponibles en este artículo, a no ser que exista otra disposición del autor. * Cada término de los Descriptores de Ciencias de la Salud (DeCS) reportados en este artículo ha sido verificado por el editor en la Biblioteca Virtual de Salud (BVS) de la edición actualizada a marzo de 2016, el cual incluye los términos MESH, MEDLINE y LILACS (http://decs.bvs.br/E/ homepagee.htm). TRABAJO ORIGINALREVISTA MÉDICA HJCA RESUMEN INTRODUCCIÓN: El lupus miliar diseminado facial ha sido reportado de forma infrecuente al tiempo que ha recibido múltiples denominaciones. Se caracteriza clínicamente por pá-pulas marrones eritematosas monomórficas de entre 1 y 4 mm de diámetro con cicatrices en pica -hielo similares al acné.MÉTODO: Se trató de un estudio descriptivo. Los siete casos presentados en este documento muestran las manifestaciones clínicas e histológicas de esta patología, las mismas que coinciden con lo reportado en la literatura, a excepción de un componente hiperqueratósico central en algunas lesiones, no reportando anteriormente, y que se ha corroborado con la microscopía. RESULTADOS:El correcto diagnóstico y tratamiento de los casos presentados, tuvieron una marcada disminución de lesiones en el lapso de las primeras 8 a 16 semanas. CONCLUSIONES:El lupus miliar diseminado facial es una patología subdiagnosticada cuya característica principal es la presencia de un componente hiperqueratósico folicular que involuciona dejando cicatrices en pica-hielo. El tratamiento con corticosteroides ha mostrado una mejoría en las lesiones, coincidiendo con la literatura publicada. PALABRAS CLAVES:

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Section: Introductionunclassified

Estudio Descriptivo: Granulomas Faciales Idiopáticos con Evolución Regresiva, ¿Es el Lupus Miliar Diseminado Facial un Sinónimo?

Aldás¹,

Donoso

Garzón³

et al. 2017

Rev. Méd. HJCA

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“…Small pustules may rarely accompany the papules [3,6]. Distribution tends to be symmetrical, primarily involving the central and lateral face with the lower eyelids being most frequently affected [1][2][3]5].…”

Section: Introductionmentioning

confidence: 99%

“…Distribution tends to be symmetrical, primarily involving the central and lateral face with the lower eyelids being most frequently affected [1][2][3]5]. However, multiple extrafacial sites of involvement and one case without any facial involvement have been reported [1,6,7]. Diascopy may reveal apple-jelly nodules [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…LMDF most commonly affects young adults of both sexes although cases among children and the elderly have been reported [5,8]. Spontaneous resolution of the lesions is reported to occur over 1-4 years, often leaving small, pitted scars [1,5,6]. 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 stages: early, fully developed, and late [1].…”

Section: Introductionmentioning

confidence: 99%

“…It is considered by some to be part of a spectrum between granulomatous rosacea and sarcoidosis [6]. Others postulate an immune response to pilosebaceous units or a foreign body reaction to sebum, keratin, or Demodex folliculorum from ruptured follicles [1,3,4,9].…”

Section: Introductionmentioning

confidence: 99%

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A Review of Lupus Miliaris Disseminatus Faciei-Like Histopathologic Changes in 10 Cases

Echols¹

2014

J Clin Exp Dermatol Res

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Objective: To determine the clinical and histopathologic features of all lesions diagnosed as lupus miliaris disseminatus faciei via biopsy over the past 16 years at a single institution. Clinical features reviewed included age of patient, location and number of lesions, duration, description of primary lesion, size, and suspected clinical diagnosis or differential diagnosis. Histopathologic features reviewed included presence of caseation necrosis, depth of granuloma, presence of lymphocytic infiltrate, disruption of hair follicles, and presence of multinucleated giant cells. Methods:The records of 10 patients (mean age, 50.4 years; range, 6 to 79 years) with characteristic histologic features of lupus miliaris disseminatus faciei were reviewed and the histopathologic findings and clinical features were analyzed. Formalin-fixed, paraffin-embedded specimens were examined by hematoxylin-eosin staining. Results:The most common clinical appearance was a single papule located on the face. Two cases with solitary, extrafacial distributions were reported. All cases demonstrated epithelioid granulomas with a central area of caseation necrosis. The majority of granulomas were perifollicular in location and were comprised of histiocytes, lymphocytes, and multinucleated giant cells. Conclusion:The 10 cases we report demonstrate the importance of recognizing the entity in solitary as well as extrafacial forms. Limiting the histologic diagnosis to fully developed lesions demonstrating epithelioid granulomas with caseation necrosis serves to clarify the diagnosis in the setting of diverse clinical presentations. 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.

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