No consultations are indicated. Since LMDF spontaneously resolves within 1-2 years, the impact of therapy on the course of the disease is difficult to assess. Since LMDF may represent a form of rosacea, corticosteroids may provide temporary improvement, followed by chronic flaring of the disease. Caution is advised, and corticosteroids should not be administered unless other treatment options have failed. May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity.
Class includes tetracycline, doxycycline, and minocycline.
Anti-inflammatory mechanism of action may differ from antibacterial mechanism of action. Some studies indicate that tetracyclines inhibit inflammatory cell migration and transformation of lymphocytes. How retinoids help is difficult to explain except in general terms relating to proper maturation and function of the follicular epithelium. Use of topical retinoids is not described in the literature, but presumably, they have been tried without benefit. Systemic retinoids cause severe birth defects.