Lupus Miliaris Disseminatus Faciei

Excerpt

Lupus miliaris disseminatus faciei (LMDF) is primarily an idiopathic granulomatous disease affecting facial skin, particularly the eyelids. Nosologically, this condition is on a spectrum of facial granulomatous dermatoses and shares overlapping features with rosacea and sarcoidosis; however, a differentiating feature is the presence of caseous necrosis (separating it from sarcoidosis) and the lack of photoaggravation and erythema (separating it from rosacea). In most cases, this disorder resolves spontaneously within several years but can leave potentially disfiguring scarring.

The diagnosis was reportedly first noted in 1878 by Fox and colleagues. The name derives from a historical association with tuberculosis based on its clinical and histopathologic appearance of granulomas. More recent authors have proposed adopting the term facial idiopathic granulomas with regressive evolution instead of the entrenched LMDF. However, a name change has not appeared to be widely accepted. Older terms for a similar facial granulomatous dermatosis include micropapular tuberculid, Lewandowsky eruption, and lupoid rosacea. Acne agminata has been used to refer to similar lesions in the axilla. However, most authors consider LMDF a unique entity separate from other diagnoses.