LUPUS MILIARIS DISSEMINATUS FACIEI

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Clinical

Multiple papules occur on the face. The histology resembles tuberculosis, but no mycobacterial infection is found. Topical tacrolimus has induced a similar condition [AD 2003;139;229]. It may also occur in the axilla.

Treatment

This condition is similar to granulomatous rosacea. Oral tetracycline therapy should be tried over several months (e.g., doxycycline 100 mg BID). Isotretinoin and dapsone have been reported helpful. Untreated, spontaneous resolution over 1-3 years is common, but scarring may result.

Other therapies that have been utilized include oral and intramuscular corticosteroids, tranilast, clofazimine, oral metronidazole combined with topical tacrolimus ointment, and laser therapy (non-ablative fractionated 1,565 nm laser and a 1,450 nm diode laser).

Additional Pictures

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References

Acne agminata of the axilla. JAMA Derm 2015;151;893


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