Cases reported "Ectropion"

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1/112. Ophthalmic abnormalities in patients with cutaneous T-cell lymphoma.

    PURPOSE: To determine the frequency of ophthalmic abnormalities in patients with cutaneous T-cell lymphoma (mycosis fungoides and sezary syndrome) and T-cell lymphoma involving the skin and to describe the clinical course of the disease with selected examples. methods: A computerized diagnostic retrieval system was used to identify all patients with T-cell lymphoma involving the skin who were examined at the Mayo Clinic (Rochester, minnesota) between January 1, 1976 and December 31, 1990. The medical records of affected patients were reviewed. RESULTS: During the 15-year interval from 1976 through 1990, cutaneous T-cell lymphoma was diagnosed in 2,155 patients. Of these 2,155 patients, 42 (1.95%; 26 male and 16 female) had at least 1 ophthalmic abnormality attributable to the disease. The diagnoses in these 42 patients were mycosis fungoides in 19, clinical variants of T-cell lymphoma of the skin (most commonly, peripheral T-cell lymphoma) in 11, and sezary syndrome in 12. Cicatricial eyelid ectropion was the most common finding, affecting 17 (40.4%) of the 42 patients. Thirty-seven patients had findings that, although probably not a direct consequence of cutaneous T-cell lymphoma, have been cataloged in previous studies. CONCLUSION: Although ophthalmic abnormalities in patients with cutaneous T-cell lymphoma are relatively uncommon, the manifestations of the disease are diverse and frequently difficult to treat. ( info)

2/112. Orbicularis oculi myocutaneous flap in reconstruction of postburn lower eyelid ectropion.

    The management of postburn lower eyelid ectropion is difficult, since the contraction of the skin graft may give rise to secondary deformities especially around the lateral 1/3 of the lower eyelid. In this paper, the results of reconstruction in lower eyelid ectropion with a laterally based orbicularis oculi myocutaneous flap from the upper eyelid in 7 young patients are presented. Satisfactory function and cosmesis were obtained in the evaluation of the patients up to 40 months follow-up. The method proved versatile as the donor scar was well-hidden in the supratarsal fold and the temporally based myocutaneous flap provided additional support to the lower eyelid by exerting an upward pull against the gravity. It is concluded that usage of this flap in postburn ectropion cases is worthwhile to avoid any recurrences. reserved. ( info)

3/112. Peters' anomaly: dominant inheritance in one pedigree and dextrocardia in another.

    Two case reports are described to illustrate the unusual occurrence of dominant inheritance of Peters' anomaly and the concomitant occurrence of Peters' anomaly with colobomatous microphthalmos and dextrocardia. Studies of additional families are necessary to determine conclusively the pathogenesis, genetic mode of inheritance, ocular and systemic associated malformations, and proper management of this complex entity. ( info)

4/112. Malar fat pad elevation: An aid to closure.

    BACKGROUND: In closure of defects inferior to the eye, it is important to avoid inducing lower lid ectropion. OBJECTIVE: To describe a new technique for closure of defects inferior and lateral to the eye. methods: A case of malar fat pad elevation to close a post-Mohs surgical defect is described and the procedure is detailed. RESULTS: This technique enabled good wound closure with minimal tension and avoided the complication of ectropion. A transient asymmetry was manifest postoperatively. CONCLUSION: Malar fat pad elevation is an effective and elegant means of closing defects inferior and lateral to the eye. This technique minimizes extensive tissue undermining and movement with its consequences of postoperative tissue swelling, bruising, and hematoma formation. The side effect of ectropion is prevented. ( info)

5/112. The tarsal sandwich: a new technique in lateral canthoplasty.

    PURPOSE: Trauma and infection sometimes produce lower lid malpositions that are difficult to repair cosmetically with standard canthoplasty techniques. A new variation is described. methods: Surgical techniques of the tarsal strip canthoplasty and of lateral tarsorrhaphy are combined into the tarsal sandwich. RESULTS: Representative cases with preoperative and postoperative photos are presented. CONCLUSION: The sandwich technique allows the surgeon more flexibility in achieving the necessary vertical lift of the lateral canthus in difficult cases of entropion, ectropion, and lagophthalmos. ( info)

6/112. Grzybowski's generalized eruptive keratocanthomas: a case report.

    A 47-year old woman with Grzybowski's generalised eruptive keratoacanthomas is described. There was no history of skin disease in her family, except for an uncle's basal cell carcinoma. From 1995 she developed multiple lesions of various size, ranging from hundreds of small follicular lesions to large typical keratoacanthomas up to 5 cm in diameter, scleroderma-like facial skin and marked ectropion. Histological examination of small and large skin lesions was typical of keratoacanthoma, and no human papillomavirus was detected by polymerase chain reaction. Oral treatment with acitretin had no effect. Both cyclophosphamide and methotrexate therapy were refused by the patient despite the progressive course of the disease. Blepharoplastic surgery had some effect on eye symptoms. The etiology of this rare disease is unknown, but is probably related to some genetic defect. ( info)

7/112. Late-onset unilateral primary developmental glaucoma associated with iridotrabecular dysgenesis, congenital ectropion uveae and thickened corneal nerves: a new neural crest syndrome?

    The association of unilateral primary developmental glaucoma with iridotrabecular dysgenesis and congenital ectropion uveae has been well documented in the literature. The glaucoma in this entity may present at birth, infancy or may develop at a later stage in life. I report the case of a child with late-onset unilateral primary developmental glaucoma due to iridotrabecular dysgenesis, congenital ectropion uveae, and who had a previously undescribed association with ipsilateral thickened corneal nerves in the stroma. ( info)

8/112. poland-Moebius syndrome: a case report.

    BACKGROUND: The primary site of pathology in Moebius syndrome is still unknown, although several studies have variably localized the lesion in the extraocular muscles, cranial nerves, or central nervous system. CASE: A 24-year-old man with poland-Moebius syndrome and acquired progressive bilateral paralytic lower eyelid ectropion is described. OBSERVATIONS: In this patient, magnetic resonance imaging studies revealed a barely detectable pontine hypoplasia and normal recti muscles. Nerve conduction studies of the facial nerves showed a severe demyelinating or dysmyelinating type of neuropathy. Bilateral lower eyelid ectropium of the patient was successfully corrected by canthal tightening procedures. CONCLUSION: Contrary to many reported cases, this patient serves as a rare example of a progressive type of poland-Moebius syndrome presumably resulting from a combination of a brainstem abnormality and a peripheral neural degenerative process. ( info)

9/112. ectropion caused by periocular dermatitis.

    A 78-year-old woman had ectropion of both lower eyelids 4 weeks after the appearance of dermatitis around the eyes. Treatment with topical corticosteroids resulted in disappearance of both dermatitis and ectropion within 10 days. No relevant contact allergies were found. Her advanced age and a familial tendency toward edema around the eyes, indicating preexisting loss of elasticity, probably facilitated this apparently rare reaction. ( info)

10/112. ectropion secondary to bolus injection of 5-fluorouracil.

    BACKGROUND: 5-fluorouracil (5-FU) targets rapidly dividing cancer cell populations. In turn, it may cause inflammation in such rapidly dividing tissues as the corneal epithelium, conjunctiva, and tear duct. inflammation may be exacerbated by pre-existing dermatologic conditions. This case report describes a rare combination of facial dermatologic toxicity and ectropion. CASE REPORT: A 76-year-old man came to us in October 1998 with symptoms of foreign body sensation, epiphora, and difficulty removing his contact lenses. His medical history was significant for 5-FU bolus injections for intestinal cancer since May 1998. Examination revealed facial erythema and eczema, ectropion, blepharitis, chemosis, lid teleangectasia, and contact lens-related corneal edema. Differential diagnoses included ocular rosacea with cicatrizing conjunctivitis and 5-FU-induced ectropion. He was treated and monitored over the subsequent several months. As of December 1998, only mild ectropion persisted. DISCUSSION: patients with 5-FU-induced ectropion experience tender, red, scaled lids, making contact lens wear difficult. Therefore, contact lens wear should be discontinued to prevent further complications. This patient's ectropion and facial eczema may have been confounded by ocular rosacea. Exacerbation of 5-FU dermatologic toxicities in patients with preexisting conditions suggests the importance of aggressive ocular prophylaxis, using frequent ocular lubrication and topical steroid preparations with concurrent medical management of pre-existing dermatologic conditions. CONCLUSION: This case illustrates a potential link between dermatologic and ocular 5-FU toxicities. Further research and better communication among health care professionals are needed to determine if prophylaxis can reduce adverse ocular events. ( info)
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