severe symmetric and chronic lower eyelid lymphedema in the setting of neck surgery and psoriasis严重的对称和慢性下眼睑水肿在颈部手术的设置和牛皮癣.pdf

Open Journal of Ophthalmology, 2012, 2, 103-109 103 /10.4236/ojoph.2012.24022 Published Online November 2012 (http://www.SciRP.org/journal/ojoph) Severe Symmetric and Chronic Lower Eyelid Lymphedema in the Setting of Neck Surgery and Psoriasis Michael E. Possin, Cat N. Burkat Oculoplastics Service, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, USA. Email: mepossin@ Received September 7th, 2012; revised October 18th, 2012; accepted October 26th, 2012 ABSTRACT Purpose: To present a patient with bilateral severe and symmetric lower lid lymphedema in the setting of previous neck surgery and chronic psoriasis, and to review the potential relationships of neck surgery, irradiation, psoriasis, and rosacea to chronic lymphedema. Design: Single case report with literature review. Methods: A 60-year-old female with long-standing psoriasis presented with a 2-year history of severe, symmetric bilateral lower eyelid edema that deve- loped after total laryngectomy and selective right neck dissection for recurrent Squamous Cell Carcinoma (SCC). 10 years prior she underwent radiation and radical left neck dissection for metastatic disease. Surgical management en- tailed transcutaneous debulking of the masses combined with ectropion repair and suture tarsorrhaphy. A comprehen- sive literature review was performed using Pubmed and Medline. Results: Surgical debulking of the soft tissue masses via a transcutaneous incision resulted in significant improvement in the patient’s lymphedema without recurrence at 5 months follow-up. Histopathologic findings were consistent with chronic eyelid lymphedema. Conclusions: Isolated eyelid lymphedema is rare, with many etiologies, and poses a diagnostic challenge. While ophthalmologists are familiar with the ocular manifestations o