Oral prednisone in the treatment of acne agminata

Acne agminata (lupus miliaris disseminatus faciei), once regarded as a tuberculide, is a facial granulomatous disease still seen in young adults in Japan, despite a decrease in the incidence of tuberculosis. Although most lesions regress within a few years, even without treatment, disfiguring scars remain on the face. We have evaluated the efficacy of low dose oral prednisone therapy because, in the past, there has been no satisfactory therapy for this condition. We have treated four patients with acne agminata with prednisone, at first 10 mg daily for 2 weeks, decreasing to 5 mg daily for 3 months. This modest dosage was found to give an excellent result in three patients and a poor result in one whose treatment was started at a much later stage of the disease than in the others. Acne agminata can be cured without scar formation when oral steroids are started in an early phase of the disease.