Successful treatment of solid persistent facial edema with isotretinoin |
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Successful treatment of solid persistent facial edema with isotretinoin

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Abstract

Solid persistent facial edema is an unusual and poorly assumed condition that is difficult to treat and can lead to substantial cosmetic disfigurement, adversely affecting a patient’s self-esteem and mental health. It can be a severe complication of acne vulgaris and rosacea, on the other hand, also may be associated with other congenital, infectious, malignant, and inflammatory processes.

Case Report

A 32-year-old man with no history of acne vulgaris, came with a 6-month history of persistent left periorbital swelling. Physical examination exposed non-erythematous, non-pitting edema of the left periorbital aspect of the face

After 3.5 months of therapy with isotretinoin, there was slight clinical progress, and night compression therapy was initiated. In 2 months, there was noteworthy clinical improvement.

Isotretinoin appears to recover solid persistent facial edema through its anti-inflammatory and immunomodulatory effects.

Isotretinoin is the most effective treatment option when it is used as a sole agent or in combination with other.

Conclusion

The use of isotretinoin to lessening the acne primarily, followed by lymph massage to decline the remaining edema, has led to clinical improvement.

The etiology of solid persistent facial edema is poorly understood. Although its presence in this patient may precede the development of an associated condition, the lack of history of significant acne vulgaris, young age, and lack of associated symptoms are unique and give credence to the possibility it is a separate disease entity apart from inflammatory skin conditions in some patients.

References 

  1. Kilinc I, Gencoglan G, Inanir I, Dereli T. Solid facial edema of acne: failure of treatment with isotretinoin. Eur J Dermatol. 2003;13(5):503-504.
  2. Friedman SJ, Fox BJ, Albert HL. Solid facial edema as a complication of acne vulgaris: treatment with isotretinoin. J Am Acad Dermatol. 1986;15(2):286-289.
  3. Bechara FG, Jansen T, Losch R, Altmeyer P, Hoffmann K. Morbihan’s disease: treatment with CO2 laser blepharoplasty. J Dermatol. 2004;31(2):113-115.
  4. Boparai RS, Levin AM, Lelli GJ Jr. Morbihan disease treatment: two case reports and a systematic literature review. Ophthalmic Plast Reconstr Surg. 2019;35(2):126-132.
  5. Smith LA, Cohen DE. Successful long-term use of oral isotretinoin for the management of Morbihan disease: a case series report and review of the literature. Arch Dermatol. 2012; 148(12):1395-1398.
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