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.