Lupus miliaris disseminatum faciei in a patient with systemic lupus erythematosus and Sjögren's syndrome.

We herein report a rare case of lupus miliaris disseminatus faciei on the chin and neck in a patient with systemic lupus erythematosus and Sjogren's syndrome. Histopathological features showed focal aggregates of epithelioid granulomas accompanied by mononuclear cell infiltration in the upper dermis. Immunohistological examination showed enhanced expression of CD68 and CD163. Recent findings have implicated a key role of innate immunity in the pathogenesis of systemic lupus erythematosus, and alteration in M1 and M2 macrophage profile has been suggested. Increased expression of CD163 in the affected skin and other organs, and elevated serum levels of soluble CD163, are reported in systemic lupus erythematosus. Our results may suggest that activated M2 macrophages participated in the induction of lupus miliaris disseminatus faciei in a patient with systemic lupus erythematosus and Sjogren's syndrome.