Sehgal Virendra N, Srivastava Govind, Aggarwal Ashok K, Belum Viswanath R, Sharma Sonal
Dermato-Venereology (Skin/VD) Centre, Sehgal Nursing Home, Panchwati, Azadpur, Delhi, India.
Skinmed. 2005 Jul-Aug;4(4):234-8.
Lupus miliaris disseminatus faciei, a chronic inflammatory disorder, is a controversial and enigmatic diagnostic/therapeutic entity. Multiple, discrete, smooth 1-3 mm brown/red or brown-to-yellowish dome-shaped papules (sometimes with mild scaling) are its clinical characteristics. The lesions are usually located on the central and lateral side of the face. The condition is most often seen in young adults of both sexes, and diascopy may reveal apple-jelly nodules. Lupus miliaris disseminatus faciei has clearly been defined into four histopathologic groups: epithelioid cell granuloma with central necrosis; epithelioid cell granuloma without central necrosis (sarcoid/foreign body reaction); epithelioid cell granuloma with abscesses; and nongranulomatous, nonspecific inflammatory infiltrate. While in early lesions granuloma is absent and lymphocytes and a few neutrophils surround the follicles, fully developed lesions show well formed granuloma surrounding ruptured hair follicles, often with large numbers of neutrophils. Lupus miliaris disseminatus faciei must be differentiated from other conditions; to facilitate this, in Part I of this paper the histopathologic undertones were delineated into early, intermediate (first stage, second stage, and third stage), and late stages. This part of the article presents an overview of lupus miliaris disseminatus faciei.
面部播散性粟粒性狼疮是一种慢性炎症性疾病，是一个存在争议且神秘的诊断/治疗实体。多个离散、光滑的1 - 3毫米棕色/红色或棕色至淡黄色圆顶状丘疹（有时有轻度鳞屑）是其临床特征。病变通常位于面部中央和侧面。这种情况最常见于年轻男女，玻片压诊可能显示苹果酱结节。面部播散性粟粒性狼疮已明确分为四个组织病理学组：伴有中央坏死的上皮样细胞肉芽肿；无中央坏死的上皮样细胞肉芽肿（结节病/异物反应）；伴有脓肿的上皮样细胞肉芽肿；以及非肉芽肿性、非特异性炎症浸润。在早期病变中没有肉芽肿，淋巴细胞和少量中性粒细胞围绕毛囊，而完全发展的病变显示围绕破裂毛囊形成良好的肉芽肿，通常有大量中性粒细胞。面部播散性粟粒性狼疮必须与其他疾病相鉴别；为便于鉴别，在本文第一部分将组织病理学特征分为早期、中期（第一阶段、第二阶段和第三阶段）和晚期。本文这一部分对面部播散性粟粒性狼疮进行概述。
