Lupus Miliaris Disseminatus Faciei

Lupus miliaris disseminatus faciei (LMDF) is a rare inflammatory dermatosis that primarily affects young adults. It is characterized by an asymptomatic papular eruption mainly involving the central face, typically lower portions of the eyelids, the lower portions of the forehead, the nasolabial folds, the cheeks, and the perioral areas.

Lupus miliaris disseminatus faciei (LMDF) has a spontaneously resolving course (within 1-2 years) but has the potential for scarring. Treatment is difficult and there is a lack of controlled studies.

Tetracyclines (doxycycline and minocycline) are the first-line treatment for Lupus Miliaris Disseminatus Faciei (LMDF), but they are not consistently effective.

Many other systemic treatments have been reported to be effective in some patients, including isotretinoin, dapsone, triamcinolone, isoniazid, corticosteroids, clofazimine, tranilast, anti-tuberculous drugs (alone or in association with tetracyclines), and metronidazole. Additionally, topical tacrolimus (in association with metronidazole or oral dapsone) and laser therapy using a 1565 nm non-ablative fractionated laser resurfacing and a 1450 nm diode laser have improved LMDF. Prevention of scarring may be possible with early intervention, using low-dose corticosteroids. 

The successful management of Lupus Miliaris Disseminatus Faciei (LMDF) scars has been reported using a combination of 100% trichloroacetic acid and carbon dioxide lasers.