lupus miliaris disseminatus faciei lupus miliaris disseminatus faciei lupus miliaris disseminatus faciei, also known as acne agminata, is a disease with a similar appearance to acne vulgaris. the cause of lmdf is unknown. lupus miliaris disseminatus facieiother nameslmdfspecialtydermatology lmdf usually occurs on the face, but extrafacial presentations have been reported. mycobacterium tuberculosis or its products may cause a caseous necrosis and thus maybe one of several possible causes. some authors view lmdf as a variant of granulomatous rosacea or a presentation related to demodex folliculitis. others suggest it as a new independent entity and proposed a new term: facial idiopathic granulomas with regressive evolution. misago et al. postulated lmdf as a common adult form, childhood granulomatous periorificial dermatitis as a rare childhood form, and perioral dermatitis as a peculiar form exacerbated by topical corticosteroids. there are no randomized controlled trials available for the treatment of lmdf. the usual first-line therapy is oral tetracyclines with variable success rates. dapsone, low-dose prednisolone, clofazimine, and isotretinoin have all been tried in some cases. the 1450-nm diode laser has been shown to improve lmdf.