Sagging eyelids and thickening of the upper lip

Introduction It is characterized by loose eyelids and progressive thickening of the upper lip, so it is called eyelid relaxation-upper lip hypertrophy syndrome. Some patients have goiter, also known as eye-mouth-thyroid syndrome; Laffer-Ascher syndrome; Symptoms; ecchymosis; goiter-double lip syndrome. The cause is unknown. Both men and women can be affected, more common in adolescents, 1/3 of patients before the age of 10, 1/2 patients between the ages of 10 to 20 years. Eyelid relaxation syndrome, also known as eyelid lysis, atrophic eyelid ptosis, is a rare eyelid disease characterized by recurrent episodes of eyelid edema in adolescents. The skin of the eyelids becomes thinner, the elasticity disappears, the wrinkles increase, and the color changes. Clinical manifestations such as lacrimal gland prolapse, ptosis and shortening of the transverse diameter of the cleft palate.

Cause

The cause of the disease is unclear. The cause of eyelid relaxation and upper lip thickening may be autosomal dominant. Infant or childhood onset may be related to innate factors.

an examination

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Eyelid examination fundus examination

Clinical manifestations:

The disease is characterized by eyelid skin relaxation in infants or young children. It has been diagnosed since childhood. Some patients have a history of eyelid edema before the onset of symptoms. The symptoms are progressive and begin to be eyelid edema. After repeated episodes, the eyelids are loose and wrinkled, accompanied by Capillary expansion, severe eyelids can occur. From the infants and young children, the lips are repeatedly swollen, and the upper lip is swollen and thick, which can be thickened into double with the orbital relaxation or at the same time as the inflammation of the lips causes fibrosis of the lips, mucosal glandular cystic changes or inflammation of the lips. Lip shape. Simple thyroid gland and swelling occur during puberty.

Differential diagnosis

Symptoms of loose eyelids and thickening of the upper lip:

Eyelid relaxation: blepharochalasis syndrome, also known as dermatolysis palpebrarum, atrophic eyelid ptosis (ptosis atrophica), is a rare eyelid disease characterized by recurrent episodes of eyelid edema in adolescents. The skin of the eyelids becomes thinner, the elasticity disappears, the wrinkles increase, and the color changes, which can be accompanied by clinical manifestations such as lacrimal gland prolapse, ptosis and shortening of the cleft palate. In 1807, Beer first described the disease. In 1896, Fuchs called it eyelid retardation.

Upper eyelid thickening and relaxation: The head of patients with thick skin periosteal disease is a retrograde cranium, especially the upper eyelids are thick and slack, the ears and lips are also thick, especially large, and the skin of the hands and feet is also hypertrophic. The bones of the extremities and the phalanx are hypertrophied, the fingers and toes are sick, and the sacs and knee joints are effusion. The patient has pain in his limbs and his movements are awkward.

Eyelid closure is incomplete: the upper and lower eyelids cannot be completely closed, causing partial eyeball exposure, also known as rabbit eye. According to the clinical manifestations of the eye, it can be clearly diagnosed.

Eyelid drooping: also known as "hanging down." Due to insufficiency or disappearance of the levator palpebral function, or some or all of the upper jaw can not be lifted, the upper jaw is in a drooping position. Divided into complete and partial, monocular or binocular, congenital and acquired, true and false.

If congenital, check whether: 1 simple ptosis (lifting or disappearing of the diaphragm function); 2 ptosis with upper rectus muscle function weakened; 3 ptosis with other ankle deformities, such as internal hemorrhoids Skin, etc.; 4 ptosis combined with (Marcus-Gunn) mandibular blinking movement phenomenon.

If the nature is acquired, check whether: 1 traumatic eyelid or craniocerebral injury, or cervical sympathetic nerve injury; 2 disease such as myasthenia gravis; 3 mechanical such as trachoma sacral infiltration, or loss of support force of eyelids, If there is no eyeball. When there is suspected myasthenia gravis, it can be used as a test for neostigmine. When it is suspected of sympathetic drooping, it can be used as a test for hydroxyamphetamine.

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