Author: Assoc Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, 2013.
Lupus miliaris disseminatus faciei (LMDF) is an uncommon facial dermatosis. It presents with pale papules which may be confused with sarcoid or syringoma clinically. Many authors now consider LMDF to be an extreme variant of granulomatous rosacea, rather than a mycobacterial infection as previously thought.
Histology of lupus miliaris disseminatus faciei
In LMDF, sections show round granulomas with central caseating necrosis. The granulomas may appear sarcoidal or tuberculoid. The granulomas typically arise adjacent to adnexal structures. A chronicinfiltrate often accompanies the granulomas. See figures 1-4.