[ @entity4 and XXXX (Morbus Morbihan): diagnostic and therapeutic challenges].

@entity1 @entity4 @entity288 @entity6509 @entity2713
BACKGROUND: Morbus Morbihan is a rare complication of @entity6509 , consisting of a persistent lymphoedema of the upper part of the face. It has typically a chronic course, unspecific histopathological findings and an extreme refractoriness to therapy. @entity1 AND METHODS: Between February 2008 and January 2010, 5 @entity1 with Morbus Morbihan were observed at the Department of Ophthalmology of the University Medical Centre Mainz. In the present cohort study, we describe the clinical, laboratory and histological findings that led to the diagnosis. The course of the affection and the results of different therapeutic options are also reported. RESULTS: Each @entity1 underwent a complete ophthalmological examination, as well as general and dermatological consultations. All @entity1 showed facial skin alterations typical for @entity6509 . 4 out of 5 subjects underwent a lid biopsy to confirm the diagnosis of Morbus Morbihan, one @entity1 refused it. Initial treatment consisted of various systemic and local medical therapies, however, with poor success. One @entity1 had intravenous therapy with @entity288 elsewhere with no effect. We treated 3 cases with intralesional @entity2713 injections with good results. 2 @entity1 underwent upper lid blepharoplasty. Results of surgery remained stable also due to manual lymph drainage and intralesional injections of triamcinolon. No complications or side effects were seen in @entity1 treated with @entity2713 . CONCLUSIONS: Morbus Morbihan can be diagnosed only after excluding other conditions leading to chronic lid swelling. In our series, good results were achieved with intralesional injection of @entity2713 . Surgery also led to relevant improvements for a long period (13 months), with some adjuvant therapy. The treatment of chronic eyelid @entity4 associated with @entity6509 remains a challenge for the ophthalmologist and the oculoplastic surgeon.
