Lupus miliaris disseminatus faciei

Lupus miliaris disseminatus faciei (LMDF) is a rare, chronic, self-limiting dermatosis that primarily affects the face. It was first described in 1878 by the British dermatologist Robert Willan. The condition is characterized by the presence of small, reddish-brown papules on the face, particularly around the eyes and on the cheeks. The exact cause of LMDF is unknown, but it is thought to be a form of granulomatous rosacea or a variant of tuberculosis of the skin.

Etiology

The exact cause of LMDF is unknown. Some researchers believe it is a form of granulomatous rosacea, while others believe it is a variant of cutaneous tuberculosis. However, the presence of Mycobacterium tuberculosis has not been consistently demonstrated in affected individuals, and anti-tuberculosis treatments are not consistently effective, suggesting that the condition may not be directly related to tuberculosis.

Clinical Features

LMDF is characterized by the presence of small, reddish-brown papules on the face, particularly around the eyes and on the cheeks. The papules are typically 1-2 mm in diameter and may be accompanied by mild itching or burning. The condition is chronic and self-limiting, with symptoms typically resolving on their own within 1-2 years.

Diagnosis

Diagnosis of LMDF is typically based on the characteristic clinical features and confirmed by skin biopsy. The biopsy typically shows a granulomatous inflammation in the dermis, with caseation necrosis often present.

Treatment

There is no specific treatment for LMDF. The condition is self-limiting and symptoms typically resolve on their own within 1-2 years. In some cases, topical or oral corticosteroids may be used to help manage symptoms. Other treatments that have been used with varying success include antibiotics, isotretinoin, and dapsone.

Epidemiology

LMDF is a rare condition. It can affect individuals of any age, but is most commonly seen in adults between the ages of 20 and 40. The condition affects both men and women, but appears to be slightly more common in women.

See Also

• Dermatology
• Rosacea
• Tuberculosis