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Double lip surgical correction in Ascher's syndrome: diagnosis and treatment of a rare condition.

Santos PP, Alves PM, Freitas VS, Souza LB - Clinics (Sao Paulo) (2008)

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Ascher’s syndrome is a rare disease first described in 1920 by Ascher, an ophthalmologist from Prague... The disease is characterized by a double upper lip, blepharochalasis, and nontoxic thyroid enlargement, though the thyroid enlargement may be evident in only 10% to 50% of patients., These deformities, though not posing functional problems, may cause severe psychological distress to the affected person because of the disfiguring effect on smiling... The patient also presented with bilateral blepharochalasis on his upper eyelids, but there was no clinical indication of thyroid enlargement... The histopathological exam revealed minor salivary gland hyperplasia (Figure 4)... No postoperative problems occurred, and the cosmetic results were satisfactory (Figure 5)... Ascher’s (or Laffer-Ascher’s) syndrome is a combination of blepharochalasis, double lip and non-toxic thyroid enlargement that usually begins in adolescence... Angioneurotic edema on both eyelids as well as on the upper lip constitutes the main early clinical feature of this syndrome... Other reported conditions associated with double lip include bifid uvula, cleft palate, cheilitis, and facial hemangioma... The present report describes a case of Ascher’s syndrome with an incidence of double lip and blepharochalasis that presented when the patient was 20 years old... Acquired cases of the syndrome usually result from trauma, while congenital cases stem from a developmental anomaly... Furthermore, vision is often impaired... Clinical examination of our patient revealed marked ptosis of the upper eyelids bilaterally, presumably due to stretching of the levator palpebrae superioris muscle... Differential diagnosis for Asher’s syndrome should also include vascular tumors, lymphangioma, angioedema, cheilitis granulomatosis, Miescher syndrome, salivary gland tumors, inflammatory fibrous hyperplasia, sarcoidosis and plasma cell cheilitis., Reported histological findings include prominent salivary glands and mixed inflammatory cell infiltration... In our patient, we found prominent salivary glands without inflammatory cell infiltration.

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The “acessory” lip removed and sutured
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f3-22-0005: The “acessory” lip removed and sutured

Mentions: A 56-year-old male came to the clinic complaining of a disfigured upper lip. He reported having this feature since he was 20 years old, and that his son also has the same problem. The patient had no history of trauma. A double upper lip was visible during physical examination (Figure 1) only when the patient smiled. A central constriction dividing the double lip was observed, most likely due to the attachment of the upper frenulum. The patient also presented with bilateral blepharochalasis on his upper eyelids, but there was no clinical indication of thyroid enlargement. A clinical diagnosis of Ascher’s Syndrome was made and surgical correction including removal of the “accessory” lip was performed via a transverse elliptical incision under local anesthesia (Figure 2). The incision was subsequently sutured (Figure 3).


Double lip surgical correction in Ascher's syndrome: diagnosis and treatment of a rare condition.

Santos PP, Alves PM, Freitas VS, Souza LB - Clinics (Sao Paulo) (2008)

The “acessory” lip removed and sutured
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2664732&req=5

f3-22-0005: The “acessory” lip removed and sutured
Mentions: A 56-year-old male came to the clinic complaining of a disfigured upper lip. He reported having this feature since he was 20 years old, and that his son also has the same problem. The patient had no history of trauma. A double upper lip was visible during physical examination (Figure 1) only when the patient smiled. A central constriction dividing the double lip was observed, most likely due to the attachment of the upper frenulum. The patient also presented with bilateral blepharochalasis on his upper eyelids, but there was no clinical indication of thyroid enlargement. A clinical diagnosis of Ascher’s Syndrome was made and surgical correction including removal of the “accessory” lip was performed via a transverse elliptical incision under local anesthesia (Figure 2). The incision was subsequently sutured (Figure 3).

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Ascher’s syndrome is a rare disease first described in 1920 by Ascher, an ophthalmologist from Prague... The disease is characterized by a double upper lip, blepharochalasis, and nontoxic thyroid enlargement, though the thyroid enlargement may be evident in only 10% to 50% of patients., These deformities, though not posing functional problems, may cause severe psychological distress to the affected person because of the disfiguring effect on smiling... The patient also presented with bilateral blepharochalasis on his upper eyelids, but there was no clinical indication of thyroid enlargement... The histopathological exam revealed minor salivary gland hyperplasia (Figure 4)... No postoperative problems occurred, and the cosmetic results were satisfactory (Figure 5)... Ascher’s (or Laffer-Ascher’s) syndrome is a combination of blepharochalasis, double lip and non-toxic thyroid enlargement that usually begins in adolescence... Angioneurotic edema on both eyelids as well as on the upper lip constitutes the main early clinical feature of this syndrome... Other reported conditions associated with double lip include bifid uvula, cleft palate, cheilitis, and facial hemangioma... The present report describes a case of Ascher’s syndrome with an incidence of double lip and blepharochalasis that presented when the patient was 20 years old... Acquired cases of the syndrome usually result from trauma, while congenital cases stem from a developmental anomaly... Furthermore, vision is often impaired... Clinical examination of our patient revealed marked ptosis of the upper eyelids bilaterally, presumably due to stretching of the levator palpebrae superioris muscle... Differential diagnosis for Asher’s syndrome should also include vascular tumors, lymphangioma, angioedema, cheilitis granulomatosis, Miescher syndrome, salivary gland tumors, inflammatory fibrous hyperplasia, sarcoidosis and plasma cell cheilitis., Reported histological findings include prominent salivary glands and mixed inflammatory cell infiltration... In our patient, we found prominent salivary glands without inflammatory cell infiltration.

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