Acne Agminata (Lupus Miliaris Disseminatus Faciei)

Diagnosis: Acne Agminata (Lupus Miliaris Disseminatus Faciei)

Erythematous papules on the central face, particularly on and around the eyelids.

Clinical Presentation

Erythematous papules on the central face, particularly on and around the eyelids.

Clinical History

Submitted by Alaa Saad. Originally posted September 15, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Rosacea • Perioral dermatitis • Folliculitis (bacterial, fungal/pityrosporum) • Demodex folliculorum infestation • Drug-induced acneiform eruption • Keratosis pilaris

Key Learnings

• Multifactorial pathogenesis: follicular hyperkeratinization, excess sebum, C. acnes, inflammation • Isotretinoin is the only therapy that targets all four pathogenic factors • Post-inflammatory hyperpigmentation more common and persistent in skin of color • Avoid unnecessary antibiotics — limit courses to 3-4 months and combine with benzoyl peroxide

Tags: acne, agminata, lupus, miliaris, disseminatus, faciei, alaa saad