Nosology and therapeutic options for lupus miliaris disseminatus faciei

Al-Mutairi, Nawaf

doi:10.1111/j.1346-8138.2011.01244.x

Cited by 56 publications

(131 citation statements)

References 35 publications

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“…Lupus miliaris disseminatus faciei (LMDF) is an uncommon but distinct, chronic, inflammatory dermatosis characterized by abrupt development of generally asymptomatic, single to multiple, 1-3 mm brown-red, brown, to yellowish dome-shaped papules or nodules with occasional mild scaling [1][2][3][4][5]. Small pustules may rarely accompany the papules [3,6].…”

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%

“…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]. LMDF most commonly affects young adults of both sexes although cases among children and the elderly have been reported [5,8].…”

Section: Introductionmentioning

confidence: 99%

“…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]. Each stage has distinct histological findings.…”

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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…3,4 In the 1980s, many authors considered LMDF to be a variant of granulomatous rosacea, but there are many aspects that differentiate the two diseases, such as the self-limited course with scarring, equal gender distribution, caseation necrosis in the histology, as well as an absence of erythema, flushing, and telangiectasia. 4,9,10 Prevention of scarring may be possible with early intervention, using low dose corticosteroids. 3 The successful management of LMDF scars has been reported using a combination of 100% trichloroacetic acid and carbon dioxide lasers.…”

Section: 4mentioning

confidence: 99%

Lupus miliaris disseminatus faciei

SpringerReference

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Lupus miliaris disseminatus faciei is a rare inflammatory dermatosis of unknown etiology that primarily affects young adults. Clinically, it is characterized by an asymptomatic papular eruption mainly involving the central face, typically on and around the eyelids. Characteristic histopathological features include dermal epithelioid cell granulomas with central necrosis and surrounding lymphocytic infiltrate with multinucleate giant cells. Lupus miliaris disseminatus faciei has a spontaneously resolving course, yet can be cosmetically debilitating given the location and potential for scarring. Treatment is difficult and there is a lack of controlled studies. We report a new case of lupus miliaris disseminatus faciei successfully treated with minocycline and systemic steroids, and briefly discuss its nosology and therapeutic options.

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