Lupus miliaris disseminatus faciei

Fox 1878.

Tuberculosis cutis miliaris disseminata faciei, disseminated follicular lupus (Tilbury Fox), tuberculosis lupoides miliaris disseminata faciei.

In the past, the disease was classified as a tuberculoid granuloma, but today it is more likely to be a granulomatous form of rosacea.

Peak in age between 30-50 yrs.

There is no relationship to tuberculosis. This is a polyaetiological skin reaction. It is most likely a granulomatous (predominantly epithelioid cell) form of rosacea.

• Erythematous bluish, often follicular papules and papulopustules. A lupoid infiltrate is seen diascopically. Partly itching is described.

• History
• Clinic, incl. diascopy
• Biopsy
• Tuberculin and quantiferon test negative

Face, capillitium, cervical and on the trunk.

Chronic course over 1-2 years. Scarring healing.

• High resistance to therapy.

• Doxycycline p.o. 100 mg 2x tgl.
• Minocycline p.o. 50 mg 2x tgl.
• Isotretinoin 0.2- 1.0 mg/ kg bw 1x tgl.
• Hydroxychloroquine initial 2x 200 mg, in the course 1x 100 mg.

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7.  Beleznay K, Friedmann DP, Liolios AM, Perry A , Goldman MP. Lupus miliaris disseminatus faciei treated with 1,565 nm nonablative fractionated laser resurfacing: a case report. Lasers Surg Med 2014;46:663-5. 
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