안면 파종상 속립성 루프스 2례

Abstract

Lupus miliaris disseminatus faciei(LMDF) is an asymptomatic papular eruption affecting the central area of the face, which runs a chronic course and involutes spontaneously with scarring. Histopathologically, the papules usually show scattered masses of tuberculoid granulomata composed of epithelioid cells, giant cells, and an encircling rim of small round mononuclear cells in the dermis. The etiology and pathogenesis of this condition are still unknown. The treatment of LMDF has not been satisfactory despite the use of many topical and systemic agents. We report two cases of LMDF, one in a 44-year-old male and the other a 25-year-old male. In the first case, asymptomatic multiple minute erythematous papules noted on the perioral, cheek, upper and lower eyelids symmatrically for 2 months. In the second case, multiple minute red papules and pustules noted on the periorbital, nose, forehead, cheek and chin symmatrically for 4 months. Histological findings shows scattered individual tubercles composed of epithelioid cells, giant cells showing in their center large caseation necrosis. AFB stain shows no acid fast bacilli. The first case was given INH 300mg, ethambutol 600mg and minocine 100mg daily for 2 months, the eruptions were healed gradually. The second case was given INH 300mg, ethambutol 800mg and minocine 100mg daily for 10 months. Two months after treatment, the eruptions were healed gradually and the eruptions were completly healed with pitted atrophic scars, 10 months after treatment.