title: Doxycycline for treatment of blepharochalasis via inhibition of matrix metalloproteinases.
abstract: Two cases of blepharochalasis were studied. In Case 1, a 16-year-old male presented with the history and clinical features of blepharochalasis. A positive tissue biopsy for matrix metalloproteinases suggested a benefit from treatment with doxycycline. The patient remained disease-free for 18 months following commencement of doxycycline. In Case 2, a 21-year-old male with a 5-month history of swelling affecting his upper eyelids was diagnosed with blepharochalasis. He received an 8-month course of doxycycline and remained symptom-free on review 2 months after treatment cessation. While the pathogenesis of blepharochalasis has remained uncertain, an immune mechanism has been suspected. The presence of matrix metalloproteinases in the tissue biopsy of our first patient supports such an immune mechanism. As doxycycline inhibits matrix metalloproteinase activity, it may provide an effective and well-tolerated treatment alternative for cases of blepharochalasis for which surgery has previously been the only treatment option.
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, Randwick, NSW, Australia.
authors.forename: Tanya
authors.initials: T
authors.lastname: Karaconji
authors.forename: Brent
authors.initials: B
authors.lastname: Skippen
authors.forename: Nick
authors.initials: N
authors.lastname: Di Girolamo
authors.forename: Simon F
authors.initials: SF
authors.lastname: Taylor
authors.forename: Ian C
authors.initials: IC
authors.lastname: Francis
authors.forename: Minas T
authors.initials: MT
authors.lastname: Coroneo
mesh_terms: D000293:Adolescent; D004318:Doxycycline / Q000627:therapeutic use*; D004487:Edema / Q000188:drug therapy / Q000201:enzymology; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005141:Eyelid Diseases / Q000188:drug therapy* / Q000201:enzymology; D006801:Humans; D008297:Male; D061965:Matrix Metalloproteinase Inhibitors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004791:Enzyme Inhibitors; D061965:Matrix Metalloproteinase Inhibitors; D004318:Doxycycline