Lymphedema of the eyelids

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Lymphedema of the eyelids

Postby patoco » Sun Jun 11, 2006 9:41 pm

Lymphedema of the eyelids

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Chronic eyelid lymphedema and acne rosacea

Report of two cases

Francesco P. Bernardini MD1, Robert C. Kersten MD, 2, Lucie M. Khouri MD2, Muhammad Moin, FRCOphth2, Dwight R. Kulwin MD2 and Diya F. Mutasim MD3

1 Ophthalmology Clinic, S. Martino Hospital, University of Genova School of Medicine, Genova, Italy
2 The Barrett Center, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA
3 Department of Dermatology, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA

Received 10 November 1999; accepted 19 July 2000 Manuscript no. 99748. Available online 28 November 2000



The authors describe the clinical findings and surgical treatment of two patients affected by chronic eyelid lymphedema associated with facial acne rosacea.


Two interventional case reports.

Methods and intervention

The clinical diagnosis of acne rosacea was based on the physical examination and confirmed by the histopathologic findings obtained from biopsy of the involved tissue. Surgical treatment was required to address the disfiguring chronic eyelid lymphedema and to correct the resultant mechanical lower eyelid ectropion in both patients.


Surgical debulking of the affected soft tissue resulted in very satisfactory cosmetic and functional improvement in both patients.


To our knowledge, this is the first series of cases of chronic eyelid lymphedema secondary to acne rosacea reported in the ophthalmic literature. Six similar cases have been described previously in the dermatologic literature; all of which had been treated medically without satisfactory results. Surgical debulking of the involved eyelids should be considered in patients affected by persistent symptomatic rosacea lymphedema ... =iconabstr


Elephantoid oedema of the eyelids

Marzano AV, Vezzoli P, Alessi E.

Institute of Dermatological Sciences of the University of Milan and IRCCS Ospedale Maggiore of Milan, Milan, Italy.

We describe a male patient with rosacea who had a 2-year history of persistent bilateral oedema of the eyelids, leading to an elephantoid condition with blepharoptosis. An upper eyelid blepharoplasty was performed, but swelling progressively recurred over a few months. Based on the case history, clinical appearance and histological findings, rosaceous lymphoedema was considered to be the diagnosis. The latter is a bilateral, solid oedema of the mid-third of the face, regarded as a rare complication of rosacea. It is thought to occur as a result of chronic inflammation and lymphatic stasis, but its exact aethiopathogenesis remains elusive. Predominant eyelid involvement, causing severe visual impairment as in our patient, is unique.

Publication Types:
Case Reports

PMID: 15196162 [PubMed - indexed for MEDLINE] ... =iconabstr


Lymphedema of the eyelids

James JH.

Lymphedema of the eyelids is a relatively rare condition whose main effect is to obstruct vision, and it is unsightly. We present 3 cases in which the edema was treated by excision and skin grafting of the eyelid, with satisfactory functional and cosmetic results. It is suggested that a split-skin graft be used for the upper eyelid and a full-thickenss graft for the lower eyelid. The lower eyelid skin can be "de-fatted" and used as a graft, but in the more severe cases we suggest a postauricular skin graft be used.

Publication Types:
Case Reports

PMID: 643958 [PubMed - indexed for MEDLINE] ... =iconabstr


Lymphoedema of the eyelids

Kabir SM, Raurell A, Ramakrishnan V.

Department of Plastic Surgery, Castle Hill Hospital, Hull, UK.

Lymphoedema of the eyelids interfering with vision can be a very debilitating condition. The aetiology is frequently unknown. Successful treatment by debulking and skin grafting has been described in a few cases. We present a case of sudden onset of massive bilateral eyelid oedema, which was treated using staged debulking without skin grafting. However, the cosmetic result was poor in comparison with skin grafting, suggesting that skin grafting may be a better way of treating this difficult problem. Copyright 2002 The British Association of Plastic Surgeons.

Publication Types:
Case Reports

PMID: 11987952 [PubMed - indexed for MEDLINE] ... =iconabstr





EDEMA OF THE FACE ... e_face.htm


Rosacea lymphoedema of the eyelid.

Lai TF, Leibovitch I, James C, Huilgol SC, Selva D.

Oculoplastic and Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

PURPOSE: To present a patient with rosacea lymphoedema of one upper eyelid resulting in unilateral complete ptosis. METHODS: A 51-year-old white man presented with a 12-month history of progressive painless swelling of the left upper eyelid. An incisional biopsy of the upper eyelid was performed. RESULTS: The biopsy showed dermal oedema with lymphangiectasia and telangiectasia, accompanied by a mild to moderate mixed chronic inflammatory infiltrate of lymphocytes, histiocytes, plasma cells and rare eosinophils. Stains for fungi and mycobacteria were negative. The lack of lichenoid reaction, dermal mucin or lip swelling indicated a lymphoedematous manifestation of rosacea. The patient was treated with minocycline and prednisolone with no effect. CONCLUSION: Rosacea lymphoedema involving the eyelid, as in our case, is a rare complication and can present diagnostic and therapeutic challenges to the ophthalmologist.

Publication Types:
Case Reports

PMID: 15606479 [PubMed - indexed for MEDLINE] ... =iconabstr


Persistent unilateral orbital and eyelid oedema as a manifestation of Melkersson-Rosenthal syndrome.

Cocuroccia B, Gubinelli E, Annessi G, Zambruno G, Girolomoni G.

Istituto Dermopatico dell'Immacolata, IRCCS, Via Monti di Creta 104, 00167 Roma, Italy.

Melkersson-Rosenthal syndrome (MRS) is a complex neuromucocutaneous disorder characterized by localized orofacial oedema and cranial nerve dysfunction, frequently associated with minor signs, including furrowed tongue. Complete forms are rare whereas mono- and oligosymptomatic variants are more common. A 71-year-old man presented with a 2-year history of relapsing and progressively persistent oedema of the right eyelids and periorbital region. A fissured tongue and telangiectatic rosacea had been present since the age of 50 and 60 years, respectively. The patient was also affected by essential hypertension and diabetes mellitus. A skin biopsy showed a marked upper dermal oedema, and small epithelioid cell granulomas arranged in perivascular and perilymphatic location. Collections of small epithelioid cells were occasionally observed within lymphatic spaces. No acid-fast bacteria, fungi or foreign bodies were detected. Intralesional corticosteroids induced transient improvement, whereas minocycline, clofazimine and dapsone have been ineffective. MRS may present with unilateral eyelid and periorbital swelling. Differential diagnoses of such cases may include a variety of cutaneous, ophthalmic and systemic diseases.

PMID: 15649204 [PubMed - in process] ... =iconabstr
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