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Purpose: To present a patient with bilateral severe and symmetric lower lid lymphedema in the setting of previous neck surgery and chronic psoriasis, and to review the potential relationships of neck surgery, irradiation, psoriasis, and rosacea to chronic lymphedema. Design: Single case report with literature review. Methods: A 60-year-old female with long-standing psoriasis presented with a 2-year history of severe, symmetric bilateral lower eyelid edema that developed after total laryngectomy and selective right neck dissection for recurrent Squamous Cell Carcinoma (SCC). 10 years prior she underwent radiation and radical left neck dissection for metastatic disease. Surgical management entailed transcutaneous debulking of the masses combined with ectropion repair and suture tarsorrhaphy. A comprehensive literature review was performed using Pubmed and Medline. Results: Surgical debulking of the soft tissue masses via a transcutaneous incision resulted in significant improvement in the patient’s lymphedema without recurrence at 5 months follow-up. Histopathologic findings were consistent with chronic eyelid lymphedema. Conclusions: Isolated eyelid lymphedema is rare, with many etiologies, and poses a diagnostic challenge. While ophthalmologists are familiar with the ocular manifestations of rosacea such as conjunctivitis or blepharitis, it is important to consider rosacea as an etiology of eyelid lymphedema. Reviewing the history for previous surgery or radiation to the head and neck, or other dermatologic inflammatory disorders is also warranted. Rosaceous lymphedema is typically less severe than in post-surgical/radiation patients, and does not respond well to medical treatment;however, it often shows a favorable response to debulking blepharoplasty surgery, with or without skin grafting. This patient with a history of severe psoriasis and bilateral neck dissections with radiation for SCC also responded well to surgery without recurrence of lymphedema. Therefore, surgical debulking can be considered in these
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篇名 Severe Symmetric and Chronic Lower Eyelid Lymphedema in the Setting of Neck Surgery and Psoriasis
来源期刊 眼科学期刊(英文) 学科 医学
关键词 Lyphedema EYELID EDEMA PSORIASIS BLEPHAROPLASTY Rosacea EYELID LYMPHATICS FACIAL Lymphatic System FACIAL EDEMA Squamous Cell Carcinoma
年,卷(期) 2012,(4) 所属期刊栏目
研究方向 页码范围 103-109
页数 7页 分类号 R73
字数 语种
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Lyphedema
EYELID
EDEMA
PSORIASIS
BLEPHAROPLASTY
Rosacea
EYELID
LYMPHATICS
FACIAL
Lymphatic
System
FACIAL
EDEMA
Squamous
Cell
Carcinoma
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眼科学期刊(英文)
季刊
2165-7408
武汉市江夏区汤逊湖北路38号光谷总部空间
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