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Chronic Periorbital Swelling in an Elderly Man—Diagnosis
Arch Dermatol. 2003;139:1075-1080.
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Diagnosis: Melkersson-Rosenthal syndrome (MRS).
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Hematoxylin-eosin staining of the biopsy specimen revealed granulomatous inflammation with perilymphatic distribution. The granulomas, which were noncaseating, were located around and sometimes within dilated blood vessels and lymphatic channels, consistent with a true granulomatous lymphangitis. There was dermal edema with a lymphohistiocytic perivascular infiltrate. Special stains for fungi, acid-fast bacilli, spirochetes, and parasites were negative, and there was no evidence of an atypical lymphoid infiltrate or implanted foreign material.
Conservative management was adopted as the patient was largely asymptomatic. Follow-up at 5 months showed some spontaneous improvement in the edema and facial weakness.
DISCUSSION
Melkersson-Rosenthal syndrome is a rare disorder. It was first described by Melkersson in 1928 as labial edema associated with recurrent facial palsy. Rosenthal added the third feature of lingua plicata to the complex in 1931.1-3 The onset usually occurs in the second decade of life, with both sexes being equally affected.1 The pathogenesis remains unclear; genetic predisposition, . . . [Full Text of this Article]
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Arch Dermatol. 2003;139(8):1075-1080.
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