A systematic review of treatments for lupus miliaris disseminatus faciei

Summary: Abstract Body: Lupus miliaris disseminatus faciei (LMDF) is a rare granulomatous inflammatory dermatosis with limited cases documented in the literature. At present, there are no established guidelines for treating LMDF making clinical management a challenge. A systematic review of reported treatments for LMDF was conducted using PRISMA guidelines. A total of 486 studies were identified in the literature on initial search. After screening, 86 studies met inclusion criteria. On data abstraction, treatment response was graded on the following scale: complete resolution (CR), significant improvement (SI), partial response (PR), no response (NR), and deterioration (DR). The review included 179 LMDF cases, with gender specified in 176 cases (56.8% male, 43.2% female). Male patients had a mean age of 30.6 ± 10.4 years, while female patients averaged 44.8 ± 16.5 years. Notably, males demonstrated a skewed age distribution with the majority falling into the 20-39 year age range whereas females demonstrated a more standard age distribution. Lesion location was also tracked. Extrafacial lesions of the scalp, abdomen, and back were only reported in male patients. Facial lesion locations were similar across men and women. A total of 296 treatment trials were identified, encompassing 93 unique regimens. The number of cases achieving CR or SI with the following systemic treatments were documented: tetracyclines (39/100, 39%), steroids (39/48, 81.3%), dapsone (32/38, 84.2%), retinoids (17/33, 51.5%), macrolides (12/22, 54.5%), immunosuppressants and DMARDs (7/11, 63.3%), antituberculous drugs (3/8, 37.5%), antimalarials (chloroquines) (4/7, 57.1%), and biologics (6/6, 100%). This study provides a comprehensive review of treatment strategies that have been trialed for LMDF and their respective efficacies. Veronica Voronina¹, James X. Feng¹, Bethany Cucka², Natalie M. Fragoso² 1. Dartmouth College Geisel School of Medicine, Hanover, NH, United States. 2. Dermatology, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States. Clinical Research: Interventional Research