Clinical and Histopathological Insights Into Lupus Miliaris Disseminatus Faciei: A Review of 70 Cases

IF 1.6 4区 医学 Q3 DERMATOLOGY
Maryam Nasimi, Saba Bandani, Kambiz Kamyab, Ifa Etesami, Sahar Montazeri, Fatemeh Saberi, Hanie Babaie
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Abstract

Background

Lupus miliaris disseminatus faciei (LMDF) is a granulomatous inflammatory disease often manifesting on the face as red, brown, or yellow papules. Lesions can cause scarring and disfigurement. There is no standard treatment due to a limited understanding of the etiology.

Method

This review examines the clinical and histopathological characteristics of 70 LMDF patients who were diagnosed from 2016 to 2022.

Results

The patients' mean age was 32.43, with a majority being in their 20s and 30s. Females were more affected during the fourth decade and beyond. The average disease duration among patients was 7.2 months. All of them had facial involvement, mostly around the eyes and on the eyelids. Histopathological analysis revealed epithelioid granulomas with inflammatory cell infiltration and, in some cases, central caseous necrosis. A relationship between the granuloma and the pilosebaceous unit was seen in 75.7% of cases. Epidermal changes, like acanthosis, were found in 47.1% of cases. We also report the existence of linear vessels in 25 (35.7%) cases.

Conclusion

Most authors now consider LMDF a distinct entity, but because of its resemblance to other diseases like granulomatous rosacea, the diagnosis is challenging. Unlike many studies in this field, we provide a quite large sample and report telangiectasia in LMDF patients, which highlights the importance of precisely differentiating LMDF from rosacea. Delay in diagnosis and treatment increases the risk of scarring.

Overall, we believe this study provides valuable insights into the demographics and histopathology of LMDF, contributing to the understanding of this challenging skin disorder.

Abstract Image

广布性面部粟状红斑狼疮70例临床及病理分析。
背景:面部弥散性粟粒狼疮(LMDF)是一种肉芽肿性炎症性疾病,常表现为面部红色、棕色或黄色丘疹。病变会造成疤痕和毁容。由于对病因的了解有限,尚无标准的治疗方法。方法:回顾分析2016年至2022年诊断的70例LMDF患者的临床和组织病理学特征。结果:患者平均年龄32.43岁,以20、30多岁居多。女性在第四个十年及以后受到的影响更大。患者平均病程为7.2个月。他们都有面部病变,主要是眼睛周围和眼睑。组织病理学分析显示上皮样肉芽肿伴炎性细胞浸润,部分病例为中心干酪样坏死。肉芽肿与毛囊皮脂腺单位之间的关系见于75.7%的病例。47.1%的病例出现表皮变化,如棘皮病。我们还报告了25例(35.7%)病例存在线性血管。结论:大多数作者现在认为LMDF是一个独特的实体,但由于其与其他疾病如肉芽肿性酒痤疮相似,因此诊断具有挑战性。与该领域的许多研究不同,我们提供了相当大的样本并报道了LMDF患者的毛细血管扩张,这突出了精确区分LMDF与酒sacea的重要性。诊断和治疗的延误会增加疤痕形成的风险。总的来说,我们相信这项研究为LMDF的人口统计学和组织病理学提供了有价值的见解,有助于理解这种具有挑战性的皮肤疾病。
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来源期刊
CiteScore
3.20
自引率
5.90%
发文量
174
审稿时长
3-8 weeks
期刊介绍: Journal of Cutaneous Pathology publishes manuscripts broadly relevant to diseases of the skin and mucosae, with the aims of advancing scientific knowledge regarding dermatopathology and enhancing the communication between clinical practitioners and research scientists. Original scientific manuscripts on diagnostic and experimental cutaneous pathology are especially desirable. Timely, pertinent review articles also will be given high priority. Manuscripts based on light, fluorescence, and electron microscopy, histochemistry, immunology, molecular biology, and genetics, as well as allied sciences, are all welcome, provided their principal focus is on cutaneous pathology. Publication time will be kept as short as possible, ensuring that articles will be quickly available to all interested in this speciality.
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