Isolated eyelid edema in Melkersson-Rosenthal syndrome: a case series

To report the clinicopathologic features of a series of patients with Melkersson-Rosenthal syndrome (MRS).

Patients in this clinicopathological case series were identified through retrospective review. Five Caucasian patients (2 women and 3 men; age range, 46 to 73 years) with isolated eyelid swelling presented over an 11-month period to two Canadian tertiary Oculoplastic referral centres. All underwent clinical examination and had tissue biopsies.

The patients presented with non-pitting, non-pruritic, painless and recurrent eyelid swelling. None had evidence of cranial nerve palsy or fissured tongue. The duration of symptoms before referral was between 1-5 years. Histopathological examination showed granulomatous inflammation in four patients. Granulomatous folliculitis was a novel finding in three patients.

Monosymptomatic patients with MRS require a high index of suspicion. Histopathological confirmation is vital for the diagnosis.