Facial miliary lupus
Introduction
Introduction to facial miliary lupus Facial miliary lupus is also known as facial disseminated miliary lupus, follicular miliary lupus, miliary lupus-like tuberculosis or facial disseminated miliary tuberculosis. A round, unbroken pimples scattered around the face, leaving atrophic scars. The disease is better than the adult's face, especially around the eyelids, near the nose, and around the mouth and cheeks. In a few cases, lesions can occur symmetrically in the ears, neck, shoulders, and extremities. The lesion is a round papule or nodule with a diameter of 2 to 3 cm, which is light red or reddish brown and translucent. When pressed in a glassy shape, it is apple-apple color. The surface of the nodule is smooth, and the small pustule of the size of the needle can be seen at the top of some nodules, or it can form a fish crumb. The course of the disease is chronic. After months or years, the nodules fade away, leaving atrophic scars of the same size as the nodules. basic knowledge The proportion of illness: 0.0005% Susceptible people: better than adults Mode of infection: non-infectious Complications: swelling
Cause
The cause of facial miliary lupus
Etiology
In the past, this disease was considered to be a type of skin tuberculosis spread by blood. It is a variant of lupus vulgaris or tuberculosis. Although histological changes are typical of tuberculosis, patients are generally healthy and most patients are not accompanied. There are other tuberculosis, tuberculosis can not be found in the lesions, tuberculin test is often negative, anti-tuberculosis treatment is mostly ineffective, so the disease is considered to have nothing to do with tuberculosis.
In recent years, some people think that this disease is a special type of papular-like rosacea. Some scholars have found that the cellular immunity of patients with this disease is abnormal.
Pathological change
The epidermis can be seen in the vacuolar degeneration of the spine cells, the basal cytochrome is increased, and the thyroid has a typical tuberculosis structure in the lower part. It is surrounded by epithelioid cells and giant cells. The center is caseous necrosis, infiltrating collagen fibers and elastic fibers are denatured or disappeared. Thrombosis and vascular occlusion can be seen inside.
Prevention
Facial miliary lupus prevention
The disease is related to tuberculosis. Therefore, the organs of multiple tuberculosis such as the lungs should be further examined. Patients with tuberculosis should be treated as soon as possible to avoid the disease. The tuberculosis medication should be combined, appropriate, early, regular, and full-time. Therefore, it may be one of the preventive measures because the medication is not standardized, or the drug is arbitrarily stopped.
Complication
Facial miliary lupus complications Complications swelling
The skin integrity of the disease is destroyed, so it can be caused by skin bacterial infection or fungal infection, usually secondary to low body constitution, or long-term use of immunosuppressants and fungal infections such as nail fungus, such as concurrent bacterial infections may have Fever, skin swelling, ulceration and purulent secretion flow out. Severe cases can lead to sepsis, which should be brought to the attention of clinicians. At the same time, this disease can have tuberculosis infection, which can stimulate tuberculosis in other parts.
Symptom
Facial miliary lupus symptoms common symptoms pustular papule nodules
The disease is better than the adult's face, especially the eyelids, near the nose and around the mouth and cheeks. In a few cases, the skin lesions can occur symmetrically in the ears, neck, shoulders and limbs, and the lesions are round papules with a diameter of 2 to 3 cm. Or nodules, light red or reddish-brown, translucent. When pressed in a glassy shape, it is apple-apple, the nodular surface is smooth, and some small nodules of needle size can be seen at the top of some nodules, or formed into fish dander.
The nodules appear in batches, the number is variable, up to tens or hundreds, independent, and the adjacent two or three nodules can be fused together, especially in the lower eyelid, often several nodules merge into a dyke Shape, without any symptoms.
The course of the disease is chronic, and after several months or years, the nodules gradually recede, leaving atrophic scars of the same size as the nodules.
Examine
Examination of facial miliary lupus
Pathological examination: vacuolar degeneration of the spine cells, increased basal cytochrome, typical TB structure in the lower part of the dermis, epithelial-like cells and giant cells, central cheese-like necrosis, infiltration of collagen fibers and elastic fiber denaturation or Disappeared, thrombosis and vascular occlusion were seen in the blood vessels.
Diagnosis
Diagnosis and diagnosis of facial miliary lupus
diagnosis
According to the damage, the symmetry occurs in the red nodules of the face. It is pressed with a glass slide to make apple paste color, the nodules disappear, leaving atrophic depression scars, without any self-conscious symptoms, combined with pathological changes can be diagnosed.
Differential diagnosis
Rosacea
In addition to red papules on the face, telangiectasia erythema on the tip of the nose and cheeks, the hair follicles often expand, and the formation of late nasal sputum, often accompanied by seborrhea.
2. Acne vulgaris
There are many types of skin lesions. In addition to papules and pustules, nodules and cysts, there are often blackheads and facial sebum secretion is strong.
3. Papular necrotizing tuberculosis
In addition to the face, skin lesions also occur in the limbs and trunk, which are symmetrical necrotic papules.
4. Sebaceous adenoma
The scattered yellowish telangiectasia papules or nodules that occur in the center of the face have no symptoms, often accompanied by mental retardation and epilepsy.
