RESUMO
Lupus miliaris disseminatus faciei (LMDF) and granulomatous rosacea are 2 distinct inflammatory dermatoses with overlapping clinical features: reddish-yellow papular eruptions localized on the central face. Consequently, LMDF can easily be misdiagnosed as granulomatous rosacea or vice versa. Because delayed treatment in LMDF may increase chances of permanent scar formation, accurate diagnosis is important. We therefore analyzed published literature and case studies to organize the essential features differentiating LMDF from granulomatous rosacea. In addition, we report each case of LMDF and granulomatous rosacea for direct comparison.
RESUMO
Minimally invasive fractional rejuvenation was developed to overcome the drawbacks of the traditional ablative laser. The Fotona 4D laser is one of these lasers used for face lifting. This laser uses two wavelengths such as Nd-YAG 1064 and Er-YAG 2940 nm in four different modes of non-ablative and ablative fractional laser to induce bulk heating in different tissue layers of facial skin. Although the overall rate of fractional laser complications is much lower than that of traditional techniques, recent studies have shown that fractional lasers can cause complications such as acne, milia, prolonged erythema, infections, and pigmentary alterations.In this report, we present a very unique case of a 41-year-old female patient with mild comedonal acne who developed severe acne agminate-like granulomatous reaction following fractional rejuvenation laser therapy that resolved spontaneously within 2 months after laser therapy. To the best of our knowledge, this is the first case of acne agminate as a side effect of rejuvenation laser therapy.As ruptured hair follicles are proposed as a pathogenic factor in both acne agminate and developing acne following fractional laser therapies, it is recommended to cautiously use resurfacing fractional lasers or to thoroughly treat acne before laser therapy due to the risk of developing a granulomatous reaction.
Assuntos
Acne Vulgar , Terapia a Laser , Lasers de Estado Sólido , Acne Vulgar/etiologia , Acne Vulgar/cirurgia , Adulto , Cicatriz/cirurgia , Feminino , Humanos , Terapia a Laser/efeitos adversos , Lasers de Estado Sólido/efeitos adversos , Rejuvenescimento , Resultado do TratamentoRESUMO
Granulomatous facial skin lesions are a rare and challenging clinical problem. Differential diagnoses include cutaneous tuberculosis, sarcoidosis, granulomatous rosacea and acne agnimata. We reported a case of acne agminata presented with granulamatous facial papules.
RESUMO
El lupus miliar diseminado facial es una enfermedad inflamatoria granulomatosa de etiología incierta, caracterizada por pápulas eritemato-amarillentas que afectan predominantemente la región facial. Luego de 1 a 4 años puede involucionar sin tratamiento pero dejando secuelas estéticas. Existen múltiples tratamientos con respuestas variables. Presentamos un caso con respuesta favorable al tratamiento con isotretinoína, sin recaídas a la fecha, y realizamos una revisión de la literatura (AU)
Lupus miliaris disseminatus faciei is a granulomatous inflammatory disease of unknown etiology, characterized by erythematous yellowish papules predominantly affecting facial region. After 1-4 years it may involute without treatment but leaving scarring sequelae. There are multiple treatments with variable responses. A case with favorable response to isotretinoin treatment, with no relapses to date, is reported and literature review is made (AU)