Lupus Miliaris Disseminatus Faciei 颜面粟粒性播散性狼疮

Lupus Miliaris Disseminatus Faciei
Firm, yellowish-brown, 1–3 mm, monomorphous, discrete, smooth-surfaced papules present on both the butterfly and the lateral areas. The discrete papules appear as yellowish brown lesions on diascopy and as caseating epithelioid cell granulomas histologically. This patient lacks a history of flushing, does not have telangiectasia but has persistent erythema and has involvement of the eyelids. Patient was administrated with minocycline and isotretinoin therapy, but unfortunately he was not responding well. In comparison with organ-transplant medicine CYCLOSPORINE and natural herbal medication, eventually, patient decided to seek herbal TCM treatment. A picture is worth a thousand words!

lupus miliaris a7

lupus miliaris b7

颜面粟粒性播散性狼疮

蝴蝶和侧面区域均有坚实的黄褐色1-3毫米粟粒性播散性光滑表面的丘疹。离散性丘疹在玻片压诊法检查中显示为黄褐色病变,并且在组织学上显示为干酪样上皮样细胞肉芽肿。 患者无脸部潮红史,无毛细血管扩张,但是有持续性红斑,并且眼睑受累。 患者接受了二甲胺四环素和异维A酸治疗,但不幸的是他的反应不佳。 患者自行评估了器官移植药环孢霉素和植物中药,他最终决定寻求植物中药治疗。 治疗结果呢?一张图片胜过千言万语!

 

Reference:

  1. William D. James MD, Dirk M. Elston MD, James R. Treat MD, Misha A. Rosenbach MD and Isaac M. Neuhaus MD. Andrews’ Diseases of the Skin, Published January 1, 2020. Pages 231-251.e1
  2. Amiruddin D, et al: Clinical evaluation of 35 cases of lupus miliaris disseminatus faciei. J Dermatol 2010; 37: 618.
  3. Gutte R, et al: Childhood granulomatous periorificial dermatitis in children with extrafacial involvement. Indian J Dermatol Venereol Leprol 2011; 77: 703.
  4. Kim WB, Mistry N: Lupus miliaris disseminatus faciei with isolated axillary involvement. J Cutan Med Surg 2016; 20: 153.
  5. Sardana K, et al: Lupus miliaris disseminatus faciei: a resistant case with response to cyclosporine. Dermatol Ther 2017; 30: ePub 2017 Apr 26.
  6. Schaarschmidt ML, et al: Lupus miliaris disseminatus faciei. Acta Derm Venereol 2017; 97: 655.
  7. Skowron F, et al: FIGURE: facial idiopathic granulomas with regressive evolution. Dermatology 2000; 201: 289.