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Ismail A, Khalid MO, Ismail MS, Fatima U, Ashraf MF. A rare sight: Childhood blepharochalasis presenting as recurrent eyelid swelling: A case report. Int J Surg Case Rep 2024; 121:110047. [PMID: 39029214 PMCID: PMC11295543 DOI: 10.1016/j.ijscr.2024.110047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Blepharochalasis is a rare eyelid condition that usually affects the upper eyelids and is characterized by persistent, painless edema. This article emphasizes how difficult it can be to diagnose blepharochalasis and how crucial it is to take it into account when making a differential diagnosis for recurrent eyelid swelling. Additionally, it highlights the necessity of surgical intervention and the limited effectiveness of medicinal therapy. CASE PRESENTATION This case report features a 12-year-old kid who has experienced recurring swelling of the upper eyelid for the previous six years. This was eventually diagnosed as a rare condition called blepharochalasis, and treated with blepharoplasty. CLINICAL DISCUSSION When nephrotic syndrome was first suspected, systemic involvement was ruled out by careful investigation. Upon physical examination, there was laxity of the eyelids and bilateral ptosis. Renal and liver function tests, among other laboratory testing, came back within normal ranges. The patient was sent to plastic surgery and had blepharoplasty. CONCLUSION Blepharochalasis presents with recurrent eyelids swelling and is often misdiagnosed as other pathologies such as nephrotic syndrome. This case highlights the importance of clinical manifestation and management of blepharochalasis.
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Affiliation(s)
- Ahmad Ismail
- King Edward Medica University, Lahore 54000, Punjab, Pakistan.
| | | | | | - Urooj Fatima
- Faisalabad Medical University, Faisalabad, Pakistan
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Rewri P, Garg S, Kumar R, Gupta G. A Century of Laffer-Ascher Syndrome. Indian J Plast Surg 2023; 56:540-543. [PMID: 38105880 PMCID: PMC10721364 DOI: 10.1055/s-0043-1776140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
Laffer-Ascher syndrome is characterized by double lips, blepharochalasis, and nongoiter thyroid enlargement. The syndrome was first described in 1923 and several case reports have been published thereafter. We illustrate the syndrome through a case of a 46-year-old woman who presented with both upper and lower double lips and blepharochalasis, and review the literature published. Thyroid involvement is the most inconsistent feature of the syndrome complex described in reported cases.
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Affiliation(s)
- Parveen Rewri
- Department of Ophthalmology, Maharaja Agrasen Medical College, Agroha (Hisar), Haryana, India
| | - Swapnil Garg
- Department of General Surgery, Maharaja Agrasen Medical College, Agroha (Hisar), Haryana, India
| | - Rajender Kumar
- Department of General Surgery, Maharaja Agrasen Medical College, Agroha (Hisar), Haryana, India
| | - Gulab Gupta
- Department of Pathology, Manglam Diagnostics, Hisar, Haryana, India
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Na J, Wu Y. Morbihan disease misdiagnosed as senile blepharoptosis and successfully treated with short-term minocycline and ketotifen: A case report. World J Clin Cases 2023; 11:4692-4697. [PMID: 37469741 PMCID: PMC10353504 DOI: 10.12998/wjcc.v11.i19.4692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/31/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Morbihan disease is a rare skin condition with diagnostic and therapeutic challenges. Facial nonpitting erythematous edema is usually considered to be a characteristic manifestation and diagnostic clue for the Morbihan disease. Treatment of Morbihan disease remains a dilemma due to its long course, poor response, and high recurrence rate.
CASE SUMMARY We report the case of a 69-year-old man with Morbihan disease. The patient presented ptosis as the first and main symptom. There was no obvious edema or other skin lesions. The patient was misdiagnosed with senile blepharoptosis based on eyelid performance and no treatment was administered to him. After continuous progressive asthenia of eye-opening and ptosis for more than one year, a skin biopsy was recommended. Histopathological analysis showed edema in the dermis, lymphatic hyperplasia and dilatation, and perivascular lymphocytic infiltration. An obvious increase in toluidine blue-stained mast cells was observed. The patient was finally diagnosed with Morbihan disease. Minocycline and ketotifen were prescribed based on the increase of mast cells in skin tissue slices. The patient experienced rapid relief seven days later and complete remission after 40 d from the commencement of the treatment.
CONCLUSION Ptosis without obvious swelling could be the only or main clinical manifestation of Morbihan disease in rare conditions. An increase of mast cells was an important therapeutic clue to the rapid and remarkable efficiency of the combination therapy of minocycline and antihistamine.
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Affiliation(s)
- Jun Na
- Department of Dermatology, Peking University First Hospital, Beijing 100034, China
| | - Yan Wu
- Department of Dermatology, Peking University First Hospital, Beijing 100034, China
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Managing the Asian Eyelid. Facial Plast Surg Clin North Am 2022. [DOI: 10.1016/j.fsc.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Atypical blepharochalasis syndrome: Case report. J Fr Ophtalmol 2021; 45:e63-e64. [PMID: 34782123 DOI: 10.1016/j.jfo.2021.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/05/2021] [Accepted: 05/11/2021] [Indexed: 11/20/2022]
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Zhou J, Ding J, Li D. Blepharochalasis: clinical and epidemiological characteristics, surgical strategy and prognosis-- a retrospective cohort study with 93 cases. BMC Ophthalmol 2021; 21:313. [PMID: 34454463 PMCID: PMC8399824 DOI: 10.1186/s12886-021-02049-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 07/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blepharochalasis is a rare eyelid disorder but eventually leading to destructive eyelid deformation. Until now the clinical and epidemiological data are unavailable. This study aimed to report the manifestations, epidemiological characteristics and surgical strategy of a large series of blepharochalasis patients with long-term follow-up. The prognosis of different clinical deformities was also investigated. METHODS This was a retrospective cohort study, including consecutive patients diagnosed with blepharochalasis in a single center. Blepharoplasty and other surgical approaches were performed according to manifestations, after a 2-year quiescent period with no recurrent attacks and exacerbation of lesions. Prognosis after surgery was recorded. RESULTS A total of 93 patients, with a mean age of 30.77 ± 14.04 (range: 9.00-70.00) years were included. Of all those 93 patients, 72.04% were females (67, P = 0.02). The mean follow-up was 5.29 ± 2.07 (range: 3-10) years before surgery, and 2.07 (range:1.54-4.22)years follow-up after surgery. The mean age of onset of blepharochalasis symptoms was 10.09 ± 3.32 (range: 5-16) years, and 83.87% patients got symptoms in puberty. With an average of 5 times per year, the mean duration of each acute attack was 28.12 ± 1.01 (rang: 2-192) hours. The mean duration from the onset of acute attack to the quiescent stage lasted for 7.33 ± 2.05 (range: 4-10) years. Most of the cases (88, 94.62%) had more than one manifestation at the end of the last follow-up before surgery. Ptosis (48.39%) was the most common deformity. Followed by lacrimal gland prolapse (44.09%), canthal angle deformity (29.04%), lower eyelid retraction (17.20%). After surgery, the functional and cosmetically acceptable results were achieved in all patients except for overcorrection in 5 (11.90%) patients with ptosis. The lacrimal gland prolapse recurred in two (4.00%) patients at 29 and 36 months after surgery. CONCLUSIONS Blepharochalasis is rare but mostly occurred in adolescent females. The process from the onset to the stable stage usually lasted for about 7 years, which might be associated with the onset of puberty. Surgical management of clinical manifestations after at least 2-year follow-up period of quiescence would be appropriate in order to observe a great plastic effect, low overcorrection and recurrence rate.
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Affiliation(s)
- Jinqiong Zhou
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Jingwen Ding
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Dongmei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Laboratory, Capital Medical University, Beijing, China.
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Blepharochalasis Syndrome Associated With Ehlers-Danlos Syndrome. Dermatol Surg 2021; 47:870-871. [PMID: 34029257 DOI: 10.1097/dss.0000000000002693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nagano H, Domoto T, Azuma R, Kiyosawa T. Stepwise surgery with variable adjustments for severe blepharochalasis with multiple chemical sensitivity: a case report. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2020; 7:20-22. [PMID: 32128348 PMCID: PMC7033695 DOI: 10.1080/23320885.2020.1719108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/17/2020] [Indexed: 11/19/2022]
Abstract
We report a 29-year-old man with blepharochalasis and multiple chemical sensitivity (MCS). Although standard blepharoplasty with aponeurotic fixation was performed, palpebral ptosis recurred after 3 months. Eyelid function and appearance improved after additional operations. A stepwise surgical approach is appropriate in patients with blepharochalasis and MCS.
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Affiliation(s)
- Hisato Nagano
- Department of Plastic and Reconstructive Surgery, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Takashi Domoto
- Department of Plastic and Reconstructive Surgery, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Ryuichi Azuma
- Department of Plastic and Reconstructive Surgery, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Tomoharu Kiyosawa
- Department of Plastic and Reconstructive Surgery, National Defense Medical College Hospital, Tokorozawa, Japan
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Zhao ZL, Wang SM, Shao CY, Fu Y. Ascher syndrome: a rare case of blepharochalasis combined with double lip and Hashimoto's thyroiditis. Int J Ophthalmol 2019; 12:1044-1046. [PMID: 31236366 DOI: 10.18240/ijo.2019.06.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 12/12/2018] [Indexed: 01/23/2023] Open
Affiliation(s)
- Zhan-Lin Zhao
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China.,Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Sheng-Ming Wang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Chun-Yi Shao
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Yao Fu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
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Dantas S, Trope B, de Magalhães T, Azulay D, Quintella D, Ramos-e-Silva M. Blepharochalasis: A Rare Presentation of Cutis Laxa. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Blepharochalasis: A rare presentation of cutis laxa. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:327-329. [PMID: 30722931 DOI: 10.1016/j.ad.2018.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 03/31/2018] [Accepted: 04/05/2018] [Indexed: 11/23/2022] Open
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Lacrimoplasty: a new bone fixation technique for recurrent lacrimal gland prolapse. EUROPEAN JOURNAL OF PLASTIC SURGERY 2018. [DOI: 10.1007/s00238-017-1388-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Blepharochalasis: A rare cause of eye swelling. Ann Allergy Asthma Immunol 2017; 119:402-407. [PMID: 29150067 DOI: 10.1016/j.anai.2017.07.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/24/2017] [Accepted: 07/28/2017] [Indexed: 11/23/2022]
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Kashkouli MB, Abdolalizadeh P, Abolfathzadeh N, Sianati H, Sharepour M, Hadi Y. Periorbital facial rejuvenation; applied anatomy and pre-operative assessment. J Curr Ophthalmol 2017; 29:154-168. [PMID: 28913505 PMCID: PMC5587258 DOI: 10.1016/j.joco.2017.04.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 03/21/2017] [Accepted: 04/08/2017] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Since different subspecialties are currently performing a variety of upper facial rejuvenation procedures, and the level of knowledge on the ocular and periocular anatomy and physiology is different, this review aims to highlight the most important preoperative examinations and tests with special attention to the eye and periocular adnexal structures for general ophthalmologist and specialties other than oculo-facial surgeons in order to inform them about the fine and important points that should be considered before surgery to have both cosmetic and functional improvement. METHODS English literature review was performed using PubMed with the different keywords of "periorbital rejuvenation", "blepharoptosis", "eyebrow ptosis", "blepharoplasty", "eyelid examination", "facial assessment", and "lifting". Initial screening was performed by the senior author to include the most pertinent articles. The full text of the selected articles was reviewed, and some articles were added based upon the references of the initial articles. Included articles were then reviewed with special attention to the preoperative assessment of the periorbital facial rejuvenation procedures. RESULTS There were 254 articles in the initial screening from which 84 articles were found to be mostly related to the topic of this review. The number finally increased to 112 articles after adding the pertinent references of the initial articles. CONCLUSION Static and dynamic aging changes of the periorbital area should be assessed as an eyelid-eyebrow unit paying more attention to the anthropometric landmarks. Assessing the facial asymmetry, performing comprehensive and detailed ocular examination, and asking about patients' expectation are three key elements in this regard. Furthermore, taking standard facial pictures, obtaining special consent form, and finally getting feedback are also indispensable tools toward a better outcome.
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Affiliation(s)
- Mohsen Bahmani Kashkouli
- Eye Research Center, Oculo-Facial Plastic Surgery, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Abstract
PURPOSE To describe a rare case of blepharochalasis that progressed from unilateral to bilateral involvement at five years after disease onset. CASE REPORT A previously healthy five-year-old white boy presented to our hospital for a screening visual examination. He was found to have a 2-mm right eyelid ptosis with crepe-like skin and subcutaneous telangiectatic vessels. His mother noted that since the age of three, the child has been having two to seven day-long episodes of right upper eyelid swelling and edema with tenderness. The episodes eventually progressed to involving the left eyelid as well. Oral steroid taper was found to effectively resolve these exacerbations, and a diagnosis of blepharochalasis was made. CONCLUSION Blepharochalasis should be in the differential diagnosis for young children presenting with unilateral or bilateral ptosis with periorbital skin abnormalities.
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Affiliation(s)
- Douglas P Dworak
- Department of Surgery, John H. Stroger, Jr. Hospital of Cook County Division of Ophthalmology, Chicago, IL, USA
| | - Shyam A Patel
- Department of Surgery, John H. Stroger, Jr. Hospital of Cook County Division of Ophthalmology, Chicago, IL, USA
| | - Lisa S Thompson
- Department of Surgery, John H. Stroger, Jr. Hospital of Cook County Division of Ophthalmology, Chicago, IL, USA.,Department of Surgery, Medical Eye Services, IL, USA
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Browning RJ, Sanchez AT, Mullins S, Sheehan DJ, Davis LS. Blepharochalasis: something to cry about. J Cutan Pathol 2016; 44:279-282. [DOI: 10.1111/cup.12841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/28/2016] [Accepted: 05/17/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Richard J. Browning
- Department of Dermatology; Medical College of Georgia at Georgia Regents University; Augusta GA USA
| | - April T. Sanchez
- Department of Dermatology; Medical College of Georgia at Georgia Regents University; Augusta GA USA
| | | | - Daniel J. Sheehan
- Department of Dermatology; Medical College of Georgia at Georgia Regents University; Augusta GA USA
| | - Loretta S. Davis
- Department of Dermatology; Medical College of Georgia at Georgia Regents University; Augusta GA USA
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Recurrent ptosis in a patient with blepharochalasis: clinical and histopathologic findings. J Craniofac Surg 2015; 26:e52-3. [PMID: 25569415 DOI: 10.1097/scs.0000000000001081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
A 37-year-old woman presented with right upper eyelid blepharochalasis with ptosis. Right upper eyelid edema had occurred 2 to 3 times per year by 30 years old, although the frequency decreased with age. The edema occurred spontaneously and resolved within 1 to 2 days. She underwent a right levator tucking surgery at 22 years old, and the ptosis recurred 2 years postoperatively. She again underwent ptosis surgery with skin excision at 37 years old. The intraoperative findings showed a thin levator aponeurosis. The white line was therefore advanced to the upper tarsal edge, resulting in an appropriate height and curvature. Three months later, the patient's eyelid height was 1.5 mm higher with a little temporal peaking. The levator aponeurosis was histopathologically shown to contain many capillaries. The increased vascularity of the levator aponeurosis may contribute to recurrent bouts of edema resulting in stretching and disinsertion of the aponeurosis.
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Motegi SI, Uchiyama A, Yamada K, Ogino S, Takeuchi Y, Ishikawa O. Blepharochalasis: Possibly associated with matrix metalloproteinases. J Dermatol 2014; 41:536-8. [DOI: 10.1111/1346-8138.12503] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 03/29/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Sei-ichiro Motegi
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Akihiko Uchiyama
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Kazuya Yamada
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Sachiko Ogino
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Yuko Takeuchi
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
| | - Osamu Ishikawa
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Gunma Japan
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Abstract
PURPOSE OF REVIEW Periorbital edema is a common problem that deserves scrutiny. Although a variety of healthcare providers may see this clinical entity, ophthalmologists are often consulted along the way toward diagnosis. It can challenge even the most astute clinicians. A diagnosis may reveal merely a bothersome issue or potentially a sight-threatening or life-threatening problem. RECENT FINDINGS Comprehensive reviews on this topic are scarce. Textbooks are brief. There are, however, many studies in the scientific literature of notable cases of periorbital edema. The causes generally fall into the categories of infectious, inflammatory or tumors, medication related, and postsurgical or trauma. SUMMARY This article synthesizes the current literature on the topic with a case series from our institution. It aims to provide a thorough resource for all practitioners to make the prospect of triaging, diagnosing, and treating periorbital edema less daunting.
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Çakmak S, Göncü T. Lacrimal gland prolapse in two cases of blepharochalasis syndrome and its treatment. Int Ophthalmol 2013; 34:293-5. [PMID: 23543253 DOI: 10.1007/s10792-013-9766-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 03/18/2013] [Indexed: 12/01/2022]
Abstract
Blepharochalasis is a rare disorder characterized by recurrent non-painful eyelid edema, which leads to atrophy and stretching of the supporting connective tissue around the eye. As a consequence, prolapse of the lacrimal gland can occur which results in fullness in the temporal third of the upper eyelids and may cause visual field restriction or cosmetic blemish for patients. Thus, correct diagnosis is important to plan appropriate surgery and obtain a successful postoperative result. We present two young patients with lacrimal gland prolapse associated with blepharochalasis and report on their treatment.
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Affiliation(s)
- Sevın Çakmak
- Ophthalmology Department, School of Medicine, Harran University, Akbayır mah. 1019 sokak. Çırağan sitesi. D Blok No: 19 Karaköprü, 63320, Şanlıurfa, Turkey,
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Kashkouli MB, Heirati A, Pakdel F. Lacrimal gland fistula after upper eyelid blepharoplasty. Middle East Afr J Ophthalmol 2012; 18:326-7. [PMID: 22224026 PMCID: PMC3249823 DOI: 10.4103/0974-9233.90139] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
To report the first case of lacrimal gland fistula after upper eyelid blepharoplasty for blepharochalasis. Standard upper blepharoplasty and the hooding excision were performed in a female with blepharochalasis. The patient developed a fistulous tract with tearing from the incision few days after hooding excision. Fistula excision and lacrimal gland repositioning were performed. There were no complications after the repositioning procedure (6 months follow up). Prolapsed lacrimal gland and fistula formation can occur after upper blepharoplasty hooding excision.
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Affiliation(s)
- Mohsen Bahmani Kashkouli
- Eye Research Center, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Doxycycline for Treatment of Blepharochalasis via Inhibition of Matrix Metalloproteinases. Ophthalmic Plast Reconstr Surg 2012; 28:e76-8. [DOI: 10.1097/iop.0b013e31822ddf6e] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Di Rosa L, Pirrello R, Russa G, Carita S, Morreale Bubella D, Lodato G. Deep levator palpebrae superioris detachment during aponeurosis surgery via transcutaneous approach in ptosis correction. J Fr Ophtalmol 2011; 35:166-9. [PMID: 22172368 DOI: 10.1016/j.jfo.2011.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 05/22/2011] [Accepted: 06/03/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate the efficacy of deep levator palpebrae superioris - Müller's muscle complex detachment from conjunctiva and other connective tissues in order to improve post operative lid opening and levator function for ptosis surgery via the transcutaneous approach. METHODS In this retrospective study, 23 patients (29 eyelids) were surgically treated for ptosis repair between 2003 and 2008. All surgery was performed by the same surgeon. Patients were divided into 2 groups. The first group (12 patients) consisted of patients who underwent deep levator dissection during surgery; the second group (11 patients), used as control group, consisted of patients treated without deep levator dissection. Postoperative lid opening was compared in the two groups using the Mann-Whitney non-parametric test. RESULTS The comparison between change in lid opening changes between the two groups was statistically significant (P<0.01). CONCLUSIONS Deep levator detachment can be included among standard surgical steps during ptosis surgery via transcutaneous approach in order to improve postoperative lid opening and levator function.
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Affiliation(s)
- L Di Rosa
- University eye hospital, Via Liborio Giuffre' 13, 90127 Palermo, Italy.
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Gambichler T. Mid-dermal elastolysis revisited. Arch Dermatol Res 2010; 302:85-93. [PMID: 19936772 DOI: 10.1007/s00403-009-1004-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 10/22/2009] [Accepted: 10/28/2009] [Indexed: 10/20/2022]
Abstract
The clinical as well as histological data of 79 mid-dermal elastolysis (MDE) patients reported in the literature were evaluated. MDE is an acquired skin condition of the elastic tissue predominantly manifesting on the trunk and proximal extremities of young women. Most commonly observed skin changes include patches of well-circumscribed fine wrinkles (type I) and perifollicular papular protrusions (type II). Rarely, MDE may also occur with persistent reticular erythema and wrinkling (type III). The critical diagnostic histopathological feature of MDE is the selective loss of elastic fibres in the mid-dermis. Mild lymphohistiocytic infiltrates, elastophagocytosis of elastic fibres by macrophages, and even multinucleate giant cells are occasionally observed in MDE lesions. Immunohistological studies and cell culture experiments indicate that dysbalances in elastin turnover are associated with pathological degradative processes including increased elastolytic activity that finally lead to loss of elastic fibres in the mid-dermis. First-line differential diagnoses may include closely related conditions such as anetoderma, annular elastolytic giant cell granuloma, cutis laxa acquisita and pseudoxanthoma elasticum-like papillary dermal elastolysis. Future therapeutic approaches in MDE patients should focus on agents that are able to block increased elastase activity and induce elastin synthesis.
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Affiliation(s)
- Thilo Gambichler
- Department of Dermatology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany.
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