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October 1969


Arch Dermatol. 1969;100(4):493-494. doi:10.1001/archderm.1969.01610280111029

Papular Lupoid Rosacea (Rosacea-like Tuberculid of Lewandowsky? Miliary Sarcoid?) Presented by Chester M. Sidell, MD; J. Gordon Erickson, MD; Jack E. McCleary, MD; and Edward Petko, MD.  A 35-year-old white woman noted six months ago the onset of a diffuse papular eruption involving the face and upper neck, tending to spare the paranasal and perioral areas. The primary lesion is a small papule, with minimal pustule formation. There is no seborrheic diathesis, blepharitis, or ocular involvement.A tuberculin test, 1:10,000 dilution, was positive. The chest x-ray film showed inactive, calcified, hilar flecks.Treatment has consisted of hydrocortisone lotion 0.5%, staphylococcus toxoid, grenz radiation, and griseofulvin given orally, with no apparent response. Penicillin for an intercurrent infection did not alter the appearance of the skin.

Discussion  Dr. Paul Hirsch: A noncaseating sarcoidal granuloma occupies the dermis adjacent to and associated with a follicular structure. The granuloma is composed mostly of epithelioid

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