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KMID : 0363220110490070587
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Korean Journal of Dermatology
2011 Volume.49 No. 7 p.587 ~ p.594
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The Clinical and Histopathologic Features of 30 Cases of Lupus Miliaris Disseminatus Faciei
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Han Jung-Hyun
Yun Sook-Jung
Lee Jee-Bum
Kim Seong-Jin
Lee Seung-Chul
Won Young-Ho
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Abstract
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Background:Lupus miliaris disseminatus faciei (LMDF) is a rare granulomatous disease characterized by eruption of discrete red-brown, dome-shaped papules, predominantly in the lower eyelid. Histopathologically, LMDF could
present as caseous necrosis in the central area with granulomas composed of epithelioid cells and giant cells. The
pathogenesis of LMDF remains controversial. Some suspect LMDF as a kind of cutanoeus tuberculosis, but others
believe LMDF to be a variant of granulomatous rosacea or sarcoidosis.
Objective:This study aimed to investigate the clinical and histopathologic features of LMDF.
Methods:We reviewed the medical records, clinical photographs, and histopathologic slides of 30 cases of LMDF
that were evaluated in our department between February 1991 and May 2009.
Results:The average age of the affected patient was 34.6±10.9 years and the ratio of male-to-female patients was
3.3：1. The most common sites of involvement with LMDF was the eyelid (86.7%). cheek (76.7%), philtrum
(60.0%), and glabella (56.7%). On histopathologic examination, the epithelioid granulomas had a connection to
pilosebaceous structures in 66.7% of the cases. Follicular rupture (33.3%), perifollicular granulomas composed of
naked tubercles (53.2%), and sarcoidal granulomas with abscesses (23.3%) were noted. Characteristic caseous
necrosis occurred in 7 cases (23.3%). The duration of LMDF was 2 years in 26 cases (86.7%) and the lesion
improved leaving scar in 21 cases (70%).
Conclusion:We identified the histopathologic changes of LMDF as a function of disease duration. Connections of
pilosebaceous units with granulomas were commonly observed. It will be helpful to understand the pathophysiology
of LMDF.
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KEYWORD
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Granulomatous rosacea, Lupus miliaris disseminatus faciei
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