Lymphaticovenular anastomosis for Morbihan disease: a case report

Abstract

Morbihan disease (MD) is a very rare condition characterized by rosaceous or erythematous lymphedema on the upper twothirds of the face. A definitive management strategy for MD is lacking, and treatment is challenging. Herein, we present a case of persistent bilateral eyelid edema treated by lymphaticovenular anastomosis (LVA) and lymph node-vein bypass surgery. The patient experienced persistent bilateral eyelid edema. Indocyanine green lymphography was performed, and the diagnosis of bilateral facial lymphedema was confirmed. On the right side, a preauricular lymphatic vessel was anastomosed to a vein. On the left side, lymphostomy on the preauricular lymph node was done, with anastomosis to the transected proximal end of the concomitant vein of the transverse facial artery. Furthermore, a preauricular lymphatic vessel was anastomosed to a vein. Eyelid edema decreased and progressively improved on both sides. The outcome of this case suggests that LVA and lymph node-vein bypass surgery are appropriate for treating persistent eyelid edema related to MD.

Omalizumab in the treatment of Morbihan syndrome in an adolescent girl – case report and literature review

“…13 Single reports on successful lymphaticovenular anastomosis were published. 33 Recently, two cases of Chinese adult patients treated successfully off-label with tofacitinib (Janus-activated kinase inhibitor) have been described. 6 Isotretinoin is a synthetic vitamin A derivative (a stereoisomer of all-trans-retinoic acid) that causes, among others, the reduction of activity, involution and normalization of differentiation of the sebaceous glands.…”