Lupus Miliaris Disseminatus Faciei as a Diagnostic and Therapeutic Challenge in Facial Dermatoses.

Lupus miliaris disseminatus faciei (LMDF) is a rare inflammatory granulomatous dermatosis of unknown etiology, primarily affecting young adults. It presents as a symmetric papular eruption, predominantly on the mid-facial region, often leading to unsightly depressed scars. We report the case of a 28-year-old woman with persistent facial papules evolving into atrophic scars. Dermoscopy showed orange-brown globules, fine linear vessels, and scarred areas. Histology revealed epithelioid granulomas with fibrinoid necrosis and a lymphocytic infiltrate. The patient was treated with isotretinoin (20 mg/day for nine months) with partial improvement. Management of LMDF remains challenging due to the absence of standardized treatments. Therapeutic options include dapsone, oral corticosteroids, isotretinoin, biologic agents, and laser therapy. This case highlights the importance of early diagnosis and individualized treatment to minimize scarring and psychological impact.