Extreme Eyelid Lymphedema Associated With Rosacea (Morbihan Disease): Case Series, Literature Review, and Therapeutic Considerations.
OBJECTIVE
To describe severe lymphedema of the eyelids, known as Morbihan disease, a previously characterized but infrequently reported and poorly understood entity related to rosacea that features solid mid-facial and eyelid lymphedema.


METHODS
Retrospective chart review, histopathologic and immunohistochemical analysis, and pertinent literature consideration.


RESULTS
Five cases of Morbihan disease were identified. Histopathologic examination revealed pleomorphic perivascular and perilymphatic inflammation with profound lymphangiectasis and lymph stasis, thus suggesting elements of both rosacea and localized, chronic lymphedema. Multiple therapeutic interventions were performed including systemic anti-inflammatory therapy, surgical debulking, and corticosteroid injection.


CONCLUSIONS
Extreme eyelid edema associated with characteristic skin changes and histopathologic findings represents an entity known as Morbihan disease which is rare and difficult to treat. While multiple modalities have been employed with variable results, future therapeutic considerations may include the use of targeted biologic agents.
*Ophthalmic Plastic Surgery, Lions Eye Institute, Albany Medical College, Slingerlands, New York; †Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota; and ‡Department of Pathology, Albany Medical College, Albany, New York, U.S.A.
Bryant P
BP
Carruth
Dale R
DR
Meyer
Edward J
EJ
Wladis
Elizabeth A
EA
Bradley
Rami
R
Al-Rohil
David M
DM
Jones
George B
GB
Bartley
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D005141:Eyelid Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012393:Rosacea / Q000150:complications* / Q000175:diagnosis / Q000628:therapy
D000893:Anti-Inflammatory Agents