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W. Liao, S. S. Jolly, S. Brownstein, D. R. Jordan, S. Gilberg, R. Prokopetz; Lupus Miliaris Disseminatus Faciei: Report of Two Cases. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5752.
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To present 2 cases of lupus miliaris disseminatus faciei (LMDF), an asymptomatic chronic papular eruption affecting the central area of the face, especially the eyelids, to the ophthalmic community. Except for the description by Duke-Elder in 1974, to our knowledge, this condition has not been reported previously in the ophthalmic literature.
Biopsy specimens from two women with LMDF affecting their eyelids and periorbital areas were processed for pathological studies.
Histopathological examination disclosed 3 subepithelial granulomas showing a zonal pattern. Two granulomas had a central area of caseation necrosis and one had a central abscess. Special stains revealed no evidence of microorganisms. All 3 lesions contained inflamed hair follicles within the granulomatous inflammation and one lesion had hair follicles continuous with the central necrosis. One patient was treated with minocycline with gradual resolution of her papules.
Lupus miliaris disseminatus faciei may be a diagnostic dilemma for both the ophthalmologist and pathologist as illustrated in both of our patients. Our findings are consistent with the hypothesis that the granulomas develop in response to damaged and inflamed pilosebaceous apparatuses.
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