Korean J Dermatol.  2014 Sep;52(9):638-641.

Lupus Miliaris Disseminatus Faciei Associated with Milium

• Choi MJ
• Seo J
• Oh SH
• Kim DY

Abstract

Lupus miliaris disseminatus faciei (LMDF) is a chronic inflammatory disorder primarily affecting the face. A 22-year-old man presented with facial skin lesions. Physical examination revealed scattered pin-head sized erythematous to yellowish papules. Skin biopsy from the erythematous papule showed keratinous material in the layers of the thin epithelium and caseous necrosis with adjacent epitheloid granuloma and giant cells. After mechanical extractions of milium-like inflamed papules, skin lesions improved leaving an atrophic scar. LMDF was initially thought to be associated with tuberculosis infection but today it is considered a variant of rosacea. However, there have been reports of LMDF in association with epidermal cysts or milium, suggesting an abnormal immune response to the pilosebaceous unit may play a role. Damage to the pilosebaceous unit that is further complicated by milium rupture may induce inflammation resulting in LMDF. We suggest that milium or epidermal cysts may also attribute to the pathogenesis of LMDF although further studies are needed.

Keyword

Epidermal cyst; Lupus miliaris disseminatus faciei; Milium; Rosacea

MeSH Terms

Biopsy
Cicatrix
Epidermal Cyst
Epithelium
Giant Cells
Granuloma
Humans
Inflammation
Necrosis
Physical Examination
Rosacea
Rupture
Skin
Tuberculosis
Young Adult