Histological studies were made with serial sections of papular lesions in five patients with lupus miliaris disseminatus faciei (LMDF) and two with rosacea of epitheloid cell granuloma type.
In the whole seven specimens, a follicle was seen at the center of the granuloma. In the entire five specimens of LMDF, a follicular keratinous cyst surrounded by the epithelial call granuloma was found, and a caseous necrosis was present just below a keratinous material, which had a direct contact with the caseous necrosis in the four cases, and a destroyed thin wall remained between them in one case. In addition, no evidence to support that the patients with LMDF were tuberculosis, was found either clinically or in clinical examinations. Thus the presented patients with LMDF are considered to be rosacea of granulomatous type. The presence of follicular keratinous cysts, that is follicular milia, must be a characteristic feature of rosacea of LMDF type. The formation of caseous necrosis would be ascribed to a direct contact of epitheloid cell granuloma with follicular keratinous materials.
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