Clinical and Histopathological Insights Into Lupus Miliaris Disseminatus Faciei: A Review of 70 Cases

Abstract

Background

Lupus miliaris disseminatus faciei (LMDF) is a granulomatous inflammatory disease often manifesting on the face as red, brown, or yellow papules. Lesions can cause scarring and disfigurement. There is no standard treatment due to a limited understanding of the etiology.

Method

This review examines the clinical and histopathological characteristics of 70 LMDF patients who were diagnosed from 2016 to 2022.

Results

The patients' mean age was 32.43, with a majority being in their 20s and 30s. Females were more affected during the fourth decade and beyond. The average disease duration among patients was 7.2 months. All of them had facial involvement, mostly around the eyes and on the eyelids. Histopathological analysis revealed epithelioid granulomas with inflammatory cell infiltration and, in some cases, central caseous necrosis. A relationship between the granuloma and the pilosebaceous unit was seen in 75.7% of cases. Epidermal changes, like acanthosis, were found in 47.1% of cases. We also report the existence of linear vessels in 25 (35.7%) cases.

Conclusion

Most authors now consider LMDF a distinct entity, but because of its resemblance to other diseases like granulomatous rosacea, the diagnosis is challenging. Unlike many studies in this field, we provide a quite large sample and report telangiectasia in LMDF patients, which highlights the importance of precisely differentiating LMDF from rosacea. Delay in diagnosis and treatment increases the risk of scarring.

Overall, we believe this study provides valuable insights into the demographics and histopathology of LMDF, contributing to the understanding of this challenging skin disorder.