The Search for a Uniformly Effective Treatment in Patients With Lupus Miliaris Disseminatus Faciei

Kaushik, Akanksha; Kumaran, Muthu Sendhil; Chatterjee, Debajyoti; De, Dipankar

doi:10.1001/jamadermatol.2020.1069

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…In recent years, apremilast, a phosphodiesterase 4 inhibitor that downregulates pro-inflammatory mediators (tumor necrosis factor, interferon γ, and interleukins IL2, IL12, and IL23), has shown to be an emerging therapeutic option with reported clinical improvement within four weeks [9]. TNF inhibitor infliximab was also recently reported to be effective in refractory acne agminata, suggesting the role of TNF and Th1-driven IFN gamma pathways as treatment targets for refractory cases [10].…”

Section: Case Discussionmentioning

confidence: 99%

Acne agminata: dermoscopic features and a short review

Tan¹,

Goh²,

Busmanis³

et al. 2022

DOJ

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Section: Case Discussionmentioning

confidence: 99%

Acne agminata: dermoscopic features and a short review

Tan¹,

Goh²,

Busmanis³

et al. 2022

DOJ

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“…4,5 Reports of effective immunomodulatory treatment corroborate an immune-related pathogenesis. 6 The exact pathophysiology of the disease remains unclear, contributing to unsatisfactory treatment regimens. Some case reports have highlighted success with topical dapsone, 7 a combination of isotretinoin and steroids, 8 intralesional steroids, 9 oral apremilast (three cases) 6 and oral tranilast.…”

Section: Reportmentioning

confidence: 99%

“…6 The exact pathophysiology of the disease remains unclear, contributing to unsatisfactory treatment regimens. Some case reports have highlighted success with topical dapsone, 7 a combination of isotretinoin and steroids, 8 intralesional steroids, 9 oral apremilast (three cases) 6 and oral tranilast. 10 However, many agents are not reliably useful, and the self-limiting nature and rarity of the disease makes conducting clinical trials and evaluating treatment efficacy difficult.…”

Section: Reportmentioning

confidence: 99%

“…Once thought to be a variant of granulomatous rosacea, LMDF has more recently been proposed as a distinct entity induced by immune‐mediated damage to hair follicles, with subsequent production of characteristic necrotizing granulomas 4,5 . Reports of effective immunomodulatory treatment corroborate an immune‐related pathogenesis 6 . The exact pathophysiology of the disease remains unclear, contributing to unsatisfactory treatment regimens.…”

Section: Reportmentioning

confidence: 99%

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Immune profiling of lupus miliaris disseminatus faciei and successful management with anti‐tumour necrosis factor therapy

et al. 2021

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Summary Lupus miliaris disseminatus faciei (LMDF) is a chronic inflammatory dermatosis of unknown aetiology, most often seen in young adults. Although many treatments for LMDF exist, treatment guidelines have not been developed, and response to therapy is generally unpredictable. We present the results of transcriptomic analysis of LMDF lesional skin, which revealed a variety of differentially expressed genes linking LMDF to alterations in innate and adaptive T helper 1 immunity. Immunohistochemical analysis was also performed, identifying similar changes in T‐cell immune responses. Given evidence for increased tumour necrosis factor (TNF) pathway activity, our patient, who had previously been refractory to multiple treatments, was initiated on TNF inhibitor therapy with excellent response. This characterization of the LMDF immune response may lead to improved treatment of this condition.

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