Chronic eyelid lymphedema and acne rosacea - Report of two cases

Objective: The authors describe the clinical findings and surgical treatmen t of two patients affected by chronic eyelid lymphedema associated with fac ial acne rosacea. Design: Two interventional case reports. Methods and Intervention: The clinical diagnosis of acne rosacea was based on the physical examination and confirmed by the histopathologic findings o btained from biopsy of the involved tissue. Surgical treatment was required to address the disfiguring chronic eyelid lymphedema and to correct the re sultant mechanical lower eyelid ectropion in both patients. Results: Surgical debulking of the affected soft tissue resulted in very sa tisfactory cosmetic and functional improvement in both patients. Conclusions: To our knowledge, this is the first series of cases of chronic eyelid lymphedema secondary to acne rosacea reported in the ophthalmic lit erature. Six similar cases have been described previously in the dermatolog ic literature; all of which had been treated medically without satisfactory results. Surgical debulking of the involved eyelids should be considered i n patients affected by persistent symptomatic rosacea lymphedema. (C) 2000 by the American Academy of Ophthalmology.