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Choudhary R, Gupta S. Blepharochalasis with Double Lip. Indian Dermatol Online J 2024; 15:561. [PMID: 38845659 PMCID: PMC11152472 DOI: 10.4103/idoj.idoj_477_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/25/2023] [Accepted: 08/02/2023] [Indexed: 06/09/2024] Open
Affiliation(s)
- Rajat Choudhary
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, AIIMS, New Delhi, Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, AIIMS, New Delhi, Delhi, India
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2
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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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3
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Al-Hassani M, Carey B, Sanderson J, Hullah E, Escudier M. Ascher's syndrome: a rare cause of lip swelling. Ann R Coll Surg Engl 2020; 102:e216-e218. [PMID: 32777934 DOI: 10.1308/rcsann.2020.0161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ascher's syndrome is a rare, benign entity with just over 100 reported cases. The condition is characterised by a 'double' upper lip, blepharochalasis and non-toxic thyroid enlargement. It presents before the age of 20 years in the majority of cases and shows no racial or gender differences. While the exact cause is unknown, hormonal dysfunction and autosomal dominant inheritance have been suggested as possible aetiological factors. We present two cases of Ascher's syndrome referred for investigation of lip swelling.
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Affiliation(s)
| | - B Carey
- Guy's and St Thomas' NHS Foundation Trust, UK
| | - J Sanderson
- Guy's and St Thomas' NHS Foundation Trust, UK
| | - E Hullah
- Guy's and St Thomas' NHS Foundation Trust, UK
| | - M Escudier
- Guy's and St Thomas' NHS Foundation Trust, UK
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4
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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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5
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Syndrome d’Ascher. Ann Dermatol Venereol 2018; 145:804-805. [DOI: 10.1016/j.annder.2018.09.594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/11/2018] [Accepted: 09/17/2018] [Indexed: 11/23/2022]
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6
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Selected presentations of lip enlargement: clinical manifestation and differentiation. Postepy Dermatol Alergol 2018; 35:18-25. [PMID: 29599668 PMCID: PMC5872243 DOI: 10.5114/ada.2018.73160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 07/11/2017] [Indexed: 12/14/2022] Open
Abstract
Lip enlargement may be an important symptom of either systemic or local diseases. On the basis of selected age-matched clinical cases we present the possible causes of lip swelling. We describe the most representative symptoms and recommend treatment of these pathologies. We differentiate lip swelling in Miescher syndrome, monosymptomatic form of Melkersson-Rosenthal syndrome, lip swelling in erythema multiforme and Stevens-Johnson syndrome and lip hemangioma and mucous extravasation cyst. We compare different causes of lip edema and indicate the most helpful diagnostic and treatment methods.
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Donato CMG, Melo DF, Santos JDN. Do you know this syndrome? Ascher´s syndrome: clinical findings of little known triad. An Bras Dermatol 2017; 92:729-730. [PMID: 29166520 PMCID: PMC5674714 DOI: 10.1590/abd1806-4841.20177158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 05/30/2017] [Indexed: 11/22/2022] Open
Abstract
Ascher's syndrome consists of double lip, blepharochalasis and sometimes non-toxic thyroid enlargement. It is a rare, benign, rarely reported, and sometimes misdiagnosed condition that most often affects patients under 20 years old. The etiology remains unknown, although factors such as trauma, hormonal dysfunction and heredity have been suggested. Treatment based on surgical intervention is indicated to improve aesthetics or function. The presented case shows a patient diagnosed with Ascher's syndrome based on clinical findings such as double lip and blepharochalasis.
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Affiliation(s)
| | - Daniel Fernandes Melo
- Post-Graduation Program in Medical Sciences of the Universidade do Estado do Rio de Janeiro (UERJ) - Rio de Janeiro (RJ), Brazil.,Alopecia Outpatient Clinic of the Department of Dermatology at Hospital Naval Marcílio Dias (HNMD) - Rio de Janeiro (RJ), Brazil
| | - Juliana de Noronha Santos
- Oral Diagnosis Outpatient Clinic of the Department of Dermatology at Hospital Naval Marcílio Dias (HNMD) - Rio de Janeiro (RJ), Brazil.,Discipline of Oral Medicine of the Universidade Estácio de Sá - Rio de Janeiro (RJ), Brazil
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8
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Liu Z, Chen Y, Lin Z, Shi X. Ophthalmic clues to the endocrine disorders. J Endocrinol Invest 2017; 40:21-25. [PMID: 27568184 DOI: 10.1007/s40618-016-0532-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/12/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Eye is a vital sense organ and reflects the physical and mental wellbeing of a person. Detailed examination of the eye is an essential part in the clinical evaluation of patients with any systemic disorder. The interaction between ophthalmologists and endocrinologists is often limited to Graves' ophthalmopathy and diabetic retinopathy. However, there are many ophthalmic manifestations, which are characteristically seen in endocrine disorders. In this review, we shall discuss the ocular manifestations of the endocrine syndromes excluding the Graves' ophthalmopathy and diabetic retinopathy. METHODS We performed a PubMed search of articles published in English showing the ophthalmic features in the endocrine disorders. Relevant cited articles were also retrieved. RESULTS Most of the publications included in the review were case reports and review articles. Many endocrine disorders have characteristic manifestations pertaining to the various structures of the eye. The involvement is seen from the external structures of the eye to the inner most layers of the retina. Many ocular-endocrine syndromes also exist with characteristic clues to the clinical diagnosis. CONCLUSION The endocrinologists need to be aware of these ocular signs that help in the early diagnosis of the underlying disorder. A syndromic approach is essential in the diagnosis of endocrinopathy in patients presenting with ophthalmic features.
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Affiliation(s)
- Z Liu
- Department of Ophthalmology, Changchun University of Medicine, Changchun, 130000, Jilin, China
| | - Y Chen
- Department of Ophthalmology, Changchun University of Medicine, Changchun, 130000, Jilin, China
| | - Z Lin
- Department of Ophthalmology, Changchun University of Medicine, Changchun, 130000, Jilin, China
| | - X Shi
- Department of Ophthalmology, Changchun University of Medicine, Changchun, 130000, Jilin, China.
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Abstract
Plasma cell cheilitis, also known as plasma cell orificial mucositis is a benign inflammatory condition clinically characterized by erythematous plaque on lips that may be ulcerated. Histopathologically it is characterized by dense plasma cell infiltrates in a band-like pattern in dermis, which corresponds to Zoon's plasma cell balanitis. On the other hand, granulomatous cheilitis, as a part of orofacial granulomatosis, manifests as sudden diffuse or nodular swelling involving lip and cheek. Initial swelling is soft to firm, but with recurrent episodes swelling gradually become firm rubbery in consistency. We hereby report a case of cheilitis in a 52-year-old man with diffuse swelling involving lower lip, which clinically resembles granulomatous cheilitis, but histopathological examination showed diffuse infiltrate of plasma cells predominantly in upper and mid-dermis.
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Affiliation(s)
- Somenath Sarkar
- Department of Dermatology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Sarmistha Ghosh
- Department of Dermatology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Dipayan Sengupta
- Department of Dermatology, School of Tropical Medicine, Kolkata, West Bengal, India
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Urrets-Zavalía JA, Espósito E, Garay I, Monti R, Ruiz-Lascano A, Correa L, Serra HM, Grzybowski A. The eye and the skin in endocrine metabolic diseases. Clin Dermatol 2016; 34:151-65. [DOI: 10.1016/j.clindermatol.2015.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Molina S, Medard P, Galdeano M. Ascher syndrome: report of a case with early manifestations. Craniomaxillofac Trauma Reconstr 2015; 8:150-2. [PMID: 26000088 DOI: 10.1055/s-0034-1395881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 07/27/2014] [Indexed: 10/24/2022] Open
Abstract
Ascher syndrome is a disease of unknown etiology first described in 1920 by Ascher, an ophthalmologist from Prague. It presents with recurrent edema of the lip and upper eyelid resulting in double lip and blepharochalasis. In 10% of cases the idiopathic nontoxic thyroid enlargement also occurs. Because of its rarity, it is often undiagnosed. A case of early onset is presented with its respective surgical treatment and outcome.
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Affiliation(s)
- Santiago Molina
- Department of Plastic and Reconstructive Surgery, Hospital Marcial Quiroga, San Juan, Argentina ; Department of Maxillofacial Surgery, Clinica Andina, San Juan, Argentina
| | - Pablo Medard
- Department of Pediatric Surgery, Hospital Dr. Guillermo Rawson, San Juan, Argentina
| | - Marcelo Galdeano
- Department of Pediatric Surgery, Hospital Dr. Guillermo Rawson, San Juan, Argentina
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Melkersson-Rosenthal Syndrome with Isolated Unilateral Eyelid Edema. Ophthalmic Plast Reconstr Surg 2015; 31:e70-7. [DOI: 10.1097/iop.0000000000000088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Syndrome d’Ascher Laeffer : à propos d’un cas. J Fr Ophtalmol 2015; 38:e71-2. [DOI: 10.1016/j.jfo.2014.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/20/2014] [Accepted: 05/19/2014] [Indexed: 11/24/2022]
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14
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Abstract
The human eye, as an organ, can offer critical clues to the diagnosis of various systemic illnesses. Ocular changes are common in various endocrine disorders such as diabetes mellitus and Graves' disease. However there exist a large number of lesser known endocrine disorders where ocular involvement is significant. Awareness of these associations is the first step in the diagnosis and management of these complex patients. The rare syndromes involving the pituitary hypothalamic axis with significant ocular involvement include Septo-optic dysplasia, Kallman's syndrome, and Empty Sella syndrome all affecting the optic nerve at the optic chiasa. The syndromes involving the thyroid and parathyroid glands that have ocular manifestations and are rare include Mc Cune Albright syndrome wherein optic nerve decompression may occur due to fibrous dysplasia, primary hyperparathyroidism that may present as red eye due to scleritis and Ascher syndrome wherein ptosis occurs. Allgrove's syndrome, Cushing's disease, and Addison's disease are the rare endocrine syndromes discussed involving the adrenals and eye. Ocular involvement is also seen in gonadal syndromes such as Bardet Biedl, Turner's, Rothmund's, and Klinefelter's syndrome. This review also highlights the ocular manifestation of miscellaneous syndromes such as Werner's, Cockayne's, Wolfram's, Kearns Sayre's, and Autoimmune polyendocrine syndrome. The knowledge of these relatively uncommon endocrine disorders and their ocular manifestations will help an endocrinologist reach a diagnosis and will alert an ophthalmologist to seek specialty consultation of an endocrinologist when encountered with such cases.
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Affiliation(s)
- Rupali Chopra
- Department of Ophthalmology, Christian Medical College, Ludhiana, India
| | - Ashish Chander
- Department of Ophthalmology, Christian Medical College, Ludhiana, India
| | - Jubbin J. Jacob
- Department of Medicine, Christian Medical College, Ludhiana, India
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