Bazargan Afsaneh Sadeghzadeh, Roohaninasab Masoumeh, Kahjoogh Hossein Ahmadi, Aghdam Saba Baybordi, Taheri Amirmasoud, Jafarzadeh Alireza
Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine Iran University of Medical Sciences (IUMS) Tehran Iran.
AJA University of Medical Sciences Tehran Iran.
Clin Case Rep. 2024 Aug 30;12(9):e9370. doi: 10.1002/ccr3.9370. eCollection 2024 Sep.
Pulsed dye laser (PDL) has proven effective in resolving lupus miliaris disseminatus faciei (LMDF) where drug therapies have failed with a lack of treatment consensus for LMDF, considering early PDL intervention is crucial to achieve resolution without scarring, prevent relapse, and enhance overall treatment outcomes.
Lupus miliaris disseminatus faciei (LMDF) is a rare inflammatory and granulomatous dermatologic disease that primarily affects the face. The optimal treatment for LMDF remains controversial, and there is a lack of consensus on the most effective therapy. This case report highlights the successful use of a 595 nm pulsed dye laser (PDL) in the treatment of LMDF following unsuccessful drug therapy. A 28-year-old male presented with reddish-brown eruptions on his face that had persisted for several months. Clinical examination revealed discrete dome-shaped eruptions in clusters on the central area of the face. Histopathological examination confirmed the diagnosis of LMDF, based on the presence of epithelioid granulomas with central caseous necrosis. Previous treatment with an oral isotretinoin and methotrexate combination also failed to yield satisfactory results. After discontinuing drug therapy, the patient underwent five sessions of PDL treatment. Ten days after the first session, the eruptions began to regress without scarring. Subsequent PDL sessions led to the complete resolution of the eruptions. The patient experienced no relapse during the follow-up period. This case report suggests that PDL treatment may be an effective option for LMDF, particularly in cases where drug therapy has failed. Early initiation of laser treatment may prevent scarring, minimize the adverse effects associated with drug therapy, and reduce the risk of disease relapse. Further research and controlled trials are needed to establish the efficacy of laser therapy in the treatment of LMDF.
在治疗播散性粟粒性狼疮（LMDF）时，药物治疗失败且缺乏治疗共识的情况下，脉冲染料激光（PDL）已被证明对解决LMDF有效。考虑到早期PDL干预对于实现无瘢痕消退、预防复发以及提高总体治疗效果至关重要。
播散性粟粒性狼疮（LMDF）是一种罕见的炎症性和肉芽肿性皮肤病，主要累及面部。LMDF的最佳治疗方法仍存在争议，对于最有效的治疗方案缺乏共识。本病例报告强调了在药物治疗失败后，成功使用595纳米脉冲染料激光（PDL）治疗LMDF。一名28岁男性面部出现红棕色皮疹，持续数月。临床检查发现面部中央区域有成簇的离散圆顶状皮疹。组织病理学检查根据存在中央干酪样坏死的上皮样肉芽肿确诊为LMDF。先前口服异维A酸和甲氨蝶呤联合治疗也未取得满意效果。停止药物治疗后，患者接受了5次PDL治疗。第一次治疗10天后，皮疹开始消退且无瘢痕形成。随后的PDL治疗使皮疹完全消退。患者在随访期间未复发。本病例报告表明，PDL治疗可能是LMDF的有效选择，特别是在药物治疗失败的情况下。早期开始激光治疗可预防瘢痕形成，将与药物治疗相关的不良反应降至最低，并降低疾病复发风险。需要进一步的研究和对照试验来确定激光治疗在LMDF治疗中的疗效。
