Morbihan Syndrome

A 70-year-old man patient presented with complaints of bilateral upper-eyelid swelling (Fig. 1). Physical examination revealed dilated capillaries around the nose and cheeks with woody non-pitting edema and erythema of the bilateral upper eyelids. No pain or pruritus was noted, and blood-test results were normal. Right upper-eyelid skin biopsy revealed borderline dermatitis with perivascular and perifollicular lymphocytic infiltration and edema. Morbihan syndrome with rosacea was diagnosed and treated with oral tetracycline. The symptoms improved.

Figure 1.

The patient’s face showing dilated capillaries around the nose and bilateral cheeks and erythematous edema involving the bilateral upper eyelids at first presentation

Morbihan syndrome is a rare disorder wherein woody non-pitting edema with erythema occurs in the upper half of the face.^1–3 The etiology remains undetermined, but is considered related to rosacea and acne vulgaris.¹ Although uncommon, Morbihan syndrome should be considered a potential cause of bilateral upper-eyelid swelling, particularly when the patient has history or complications of rosacea and acne vulgaris. Other causes include infection and inflammatory, neoplastic, and miscellaneous diseases; metastases to the periorbital area should be histopathologically excluded. The pathology of Morbihan syndrome can be non-specific or show lymphocytic infiltration and edema.^{1, 2} Treatment options include oral isotretinoin or tetracycline; however, Morbihan syndrome is frequently refractory and may require surgical resection for complete recovery.^1–3

Author Contribution

S.M. was in charge of and treated the patient. S.M. and T.W. wrote the manuscript. T.W. revised the manuscript and supervised the revision and publication process.

Declarations

Consent to Participate

The author obtained written informed consent from the patient for the publication of this report and any accompanying images.