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March 1994

Red Papules on the Face With Secondary Scarring

Author Affiliations

University Hospital of Geneva (Switzerland) (Dr Puppin), and Neuchâtel (Switzerland) Dermatology Unit (Dr Gueissaz)

Arch Dermatol. 1994;130(3):371-372. doi:10.1001/archderm.1994.01690030105018

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

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