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Rosacea Lymphedema (Morbihan Disease)


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The RRDi recognizes Rosacea Lymphedema  (Morbihan Disease [Syndrome] or Morbus Morbihan) as a rosacea variant. [1] Also known as rosacea lymphoedematousn or persistent solid facial edema [2], Persistent edema of rosacea or Chronic upper facial erythematous edema. [3]

"Morbihan disease (MD) is a rare entity. Its nosography is unclear and its therapeutic management is difficult....the patient was put on isotretinoin and furosemide with slight improvement. The particularity of our observation lies in the rarity and especially in the therapeutic difficulties encountered during this disease.  [4]

It is also known as Morbihan syndrome, "a rare entity that more commonly affects women in the third or fourth decade of life." [4] "Morbihan syndrome is a rare and chronic condition. It can be difficult to treat and may require a range of interventions." [5]

Morbihan diseases should be differentiated from Melkersson-Rosenthal syndrome. [6]

More often than not, Rosacea Lymphedema is referred to as Morbihan Disease, and is often recalcitrant to therapy, is a cosmetically disturbing condition, and unfortunately mostly refractory to the therapeutic measures listed below. 

Treatments

Tripterygium wilfordii 

Omalizumab

"Reported therapy includes short-term oral isotretinoin (0.5 mg/kg/day), long-term oral isotretinoin (40-80 mg/day, 10-24 months), long-term doxycycline, combination of systemic corticosteroids and antibiotic (prednisolone 20 mg/day for 2 weeks and doxycycline 200 mg/day for 12 weeks), slow-releasing doxycycline monohydrate (40 mg/day for 6 months), long-term minocycline (50 mg/day for 4 months), and a combination of both oral retinoid and ketotifen (isotretinoin 0.7 mg/kg/day for 4 months, ketotifen 2 mg/day for 4 months). [7]

Notes 

[1] "Morbihan syndrome is a rare entity that more commonly affects women in the third or fourth decade of life. It is considered a special form of rosacea and its pathogenesis is not fully known..."

An Bras Dermatol. 2016 Sep-Oct; 91(5 Suppl 1): 157–159.
doi:  10.1590/abd1806-4841.20164291
PMCID: PMC5325027
Morbihan syndrome: a case report and literature review
Rossana Cantanhede Farias de Vasconcelos, Natália Trefiglio Eid, Renata Trefiglio Eid, Fabíolla Sih Moriya, Bruna Backsmann Braga, and Alexandre Ozores Michalany

"Morbihan disease, also known as rosacea lymphedema, is a rare persistent form of lymphedema that is associated with the disease of rosacea."

Phys Ther. 2018 Dec 18;
Complete Decongestive Therapy Is an Option for the Treatment of Rosacea Lymphedema (Morbihan Disease): Two Cases.
Kutlay S, Ozdemir EC, Pala Z, Ozen S, Sanli H

[2] "Morbihan disease is a rare entity. Its place in the nosography is uncertain. Sometimes called persistent solid facial edema, sometimes rosacea lymphoedematous. It may correspond to a particular clinico-pathological form of lymphoedema or rosacea."

Pan Afr Med J. 2018; 30: 226.
Published online 2018 Jul 26. doi: 10.11604/pamj.2018.30.226.14440
PMCID: PMC6295304; PMID: 30574244
Morbihan disease: treatment difficulties and diagnosis: a case report
Alaa Aboutaam,& Fouzia Hali, Kenza Baline, Meryem Regragui, Farida Marnissi, and Soumiya Chiheb

[3] Persistent edema of rosacea, Wikpedia

[4] Pan Afr Med J. 2018 Jul 26;30:226. doi: 10.11604/pamj.2018.30.226.14440. eCollection 2018.
Morbihan disease: treatment difficulties and diagnosis: a case report.
Aboutaam A, Hali F, Baline K, Regragui M, Marnissi F, Chiheb S.

[4] Morbihan syndrome

[5] Ophthalmic Plast Reconstr Surg. 2020 Jan 23;:
Morbihan Syndrome, a UK Case Series.

Yvon C, Mudhar HS, Fayers T, Siah WF, Malhotra R, Currie Z, Tan J, Rajak S

[6] Dermatol Online J. 2020 Jun 15;26(6):
Morbihan disease: a case report and differentiation from Melkersson-Rosenthal syndrome.
Kuraitis D, Coscarart A, Williams L, Wang A

[7] Acta Dermatovenerol Croat. 2020 Aug;28(2):118-119
Morbihan Disease - An Old and Rare Entity Still Difficult to Treat.
Jerković Gulin S, Ljubojević Hadžavdić S

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