Korean J Asthma Allergy Clin Immunol.  2007 Dec;27(4):268-272.

A Case of Melkersson-Rosenthal Syndrome Presented With Periocular Edema

Abstract

Melkersson-Rosenthal syndrome (MRS) is a rare non-caseating granulomatous disease of unknown cause that is characterized by a triad of facial edema, facial palsy and furrowed tongue. Although most reported cases of MRS involve swelling of the perioral area, it rarely involves the periocular area. We report a case of MRS involving the periocular area for the first time in Korea. A 60-year-old man presented with recurrent orofacial swelling and facial palsy. Left facial palsy was developed one year ago. Recurrent swelling around the right orbital area and eyelid developed 6 months ago. Physical examination revealed a diffuse and firm edema of the face including the eyelids, periorbital region, and cheeks without erythema, tenderness or pitting. Upon neurologic examination, the left-sided facial palsy of peripheral nerve type was noted without abnormalities in taste sense or lacrimation. Biopsy performed from edematous cutaneous lesion revealed marked dermal edema with perivascular lymphocytic infiltration, telangiectasis and a few granulomatoid histiocytic collection, which was consistent with MRS. The patient was treated with oral antihistamines and corticosteroids without clinical improvement. Physicians should consider the possibility of MRS in the presence of any chronic facial swelling and recurrent peripheral facial palsy.

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