REPORT OF A CASE
A 33-year-old man presented in June 1991 with periocular asymptomatic red papules (Figure 1) of 4 month's duration. Some papules on the chin and the eyelids had resolved spontaneously with scarring. Another clinic diagnosed the condition as a papulonecrotic tuberculid. He had been treated with oral tetracycline for 4 months and topical metronidazol for 1 month without any response. He had no history of tuberculosis, and a Mantoux test was negative. Physical and laboratory examinations were unremarkable.A biopsy specimen was obtained from a lesion on the right periocular region and was sent for hematoxylineosin (Figure 2) and Ziehl-Neelsen staining.What is your diagnosis?
DIAGNOSIS:
Lupus miliaris faciei (LMF).
HISTOPATHOLOGIC FINDINGS
The biopsy specimen revealed an epithelioid cell granuloma with central necrosis and a surrounding lymphocytic infiltrate in the upper dermis. The Ziehl-Neelsen stain (Figure 3) failed to show any acid-fast bacili.
DISCUSSION
Lupus miliaris faciei is