Lupus Miliaris Disseminatus Faciei of the Eyelids: Report of Two Cases

Abstract

Lupus miliaris disseminatus faciei is a rare chronic, asymptomatic papular eruption, most commonly affecting the central face, including the eyelids. Our 2 patients presented with the typical clinical findings of small papular lesions in which histopathologic examinations disclosed granulomatous inflammation with necrosis associated with inflamed hair follicles. Except for its description as acne agminata by Duke-Elder in 1974, to the authors' knowledge, this condition has not been reported previously in the ophthalmic literature.

Ocular Adnexal Acne Agminata

“…4 No reports of complete resolution of symptoms after surgical excision of acne agminata lesions, primarily performed for diagnostic purposes, have been previously described. 2,3 In this cohort, excision of the acne agminata lesions resulted in minimal scarring without recurrence. Based on each of the 12 patients' experiences, and the difficulties inherent to the current therapeutic armamentarium for acne agminata, complete surgical excision should be considered the standard of care in the management of this disorder.…”

Morbihan disease and extrafacial lupus miliaris disseminatus faceie: a case report

“… 5 Esteves et al reported successfully treating a patient with LMDF using oral minocycline and deflazacort, 14 while Liao et al also successfully treated a patient with LMDF of the eyelids with minocycline. 9 Conversely, in another report, a patient with LMDF of the neck and chest continued to worsen with minocycline and doxycycline treatment. 11 Our patient did respond to minocycline; however, this regimen had to be discontinued due to liver toxicity.…”

“…Contrary to its name, LMDF is not associated with systemic lupus erythematosis. 9 However, the condition has been linked to rosacea, 5 and the etiology of LMDF is likely multifactorial. 7 One proposed mechanism involves a granulomatous reaction to ruptured epidermal cysts or hair follicle destruction.…”