Slater Nathaniel, Sathe Nishad C., Rapini Ronald P.
University of Texas Health Science Center at Houston
University of Texas McGovern Medical School at Houston
Lupus miliaris disseminatus faciei (LMDF) is primarily an idiopathic granulomatous disease affecting facial skin, particularly the eyelids. Nosologically, this condition is on a spectrum of facial granulomatous dermatoses and shares overlapping features with rosacea and sarcoidosis; however, a differentiating feature is the presence of caseous necrosis (separating it from sarcoidosis) and the lack of photoaggravation and erythema (separating it from rosacea). In most cases, this disorder resolves spontaneously within several years but can leave potentially disfiguring scarring. The diagnosis was reportedly first noted in 1878 by Fox and colleagues. The name derives from a historical association with tuberculosis based on its clinical and histopathologic appearance of granulomas. More recent authors have proposed adopting the term facial idiopathic granulomas with regressive evolution instead of the entrenched LMDF. However, a name change has not appeared to be widely accepted. Older terms for a similar facial granulomatous dermatosis include micropapular tuberculid, Lewandowsky eruption, and lupoid rosacea. Acne agminata has been used to refer to similar lesions in the axilla. However, most authors consider LMDF a unique entity separate from other diagnoses.
面部播散性粟粒性狼疮（LMDF）主要是一种特发性肉芽肿性疾病，累及面部皮肤，尤其是眼睑。从疾病分类学角度来看，这种病症属于面部肉芽肿性皮肤病范畴，与酒渣鼻和结节病有重叠特征；然而，其鉴别特征在于存在干酪样坏死（将其与结节病区分开来）以及不存在光加重和红斑现象（将其与酒渣鼻区分开来）。在大多数情况下，这种疾病会在数年内自行缓解，但可能会留下潜在毁容性瘢痕。据报道，1878年福克斯及其同事首次注意到这种诊断。该名称源于基于其肉芽肿的临床和组织病理学表现与结核病的历史关联。最近的作者提议采用“具有退行性演变的面部特发性肉芽肿”这一术语，而非沿用根深蒂固的LMDF。然而，名称的更改似乎并未被广泛接受。类似面部肉芽肿性皮肤病的旧称包括微丘疹结核疹、莱万多夫斯基疹和狼疮样酒渣鼻。聚集性痤疮曾被用于指代腋窝处的类似病变。然而，大多数作者认为LMDF是一个与其他诊断不同的独特实体。
