Document Detail


Otophyma: a case report and review of the literature of lymphedema (elephantiasis) of the ear.
MedLine Citation:
PMID:  18212550     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Phymas (swellings, masses, or bulbs) are considered the end-stage of rosacea and mostly affect the nose (rhinophyma), and rarely involve the chin (gnatophyma), the cheek (metophyma), eyelids (blepharophyma), or ears (otophyma). Herein, we report the case of a 57-year-old man who developed unilateral enlargement of his left ear over 2 years. Biopsy revealed changes of rosaceous lymphedema associated with Demodex infestation. Corticosteroid and minocycline therapies resulted in partial reduction of the ear enlargement. Literature review examining for cases of lymphedema (elephantiasis) of the ear revealed that chronic inflammatory disorders (rosacea (most frequent), psoriasis, eczema), bacterial cellulitis (erysipelas), pediculosis, trauma, and primary (congenital) lymphedema can all lead to localized, lymphedematous enlargement of the ear. Depending on the severity, medical treatment directed at the inflammatory condition for mild, diffuse enlargement to surgical debulking for extensive diffuse enlargement or tumor formation can improve the signs and symptoms of otophyma. Decreased immune surveillance secondary to rosaceous lymphedema may explain why Demodex infestation is common in rosacea and support the suspicion that phymatous skin is predisposed to skin cancer development.
Authors:
J Andrew Carlson; Jill Mazza; Kenneth Kircher; Tien Anh Tran
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American Journal of dermatopathology     Volume:  30     ISSN:  1533-0311     ISO Abbreviation:  Am J Dermatopathol     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-23     Completed Date:  2008-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7911005     Medline TA:  Am J Dermatopathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  67-72     Citation Subset:  IM    
Affiliation:
Division of Dermatology, Albany Medical College, 47 New Scotland Ave., Albany, NY 12208, USA. carlsoa@mail.amc.edu
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Alcoholism
Anti-Infective Agents / therapeutic use
Anti-Inflammatory Agents / therapeutic use
Antidepressive Agents, Second-Generation / therapeutic use
Antihypertensive Agents / therapeutic use
Antilipemic Agents / therapeutic use
Dapsone / therapeutic use
Doxycycline / therapeutic use
Ear Deformities, Acquired / etiology*,  metabolism,  pathology*
Elephantiasis / etiology*,  metabolism,  pathology*
Fluoxetine / therapeutic use
Humans
Hydrochlorothiazide / therapeutic use
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Hypercholesterolemia / drug therapy
Hypertension / drug therapy
Insecticides / therapeutic use
Male
Middle Aged
Minocycline / therapeutic use
Mite Infestations / pathology
Mood Disorders / drug therapy
Permethrin / therapeutic use
Prednisone / therapeutic use
Procetofen / therapeutic use
Rosacea / complications*,  microbiology,  pathology
Triamcinolone / therapeutic use
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anti-Infective Agents; 0/Anti-Inflammatory Agents; 0/Antidepressive Agents, Second-Generation; 0/Antihypertensive Agents; 0/Antilipemic Agents; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Insecticides; 10118-90-8/Minocycline; 124-94-7/Triamcinolone; 49562-28-9/Procetofen; 52645-53-1/Permethrin; 53-03-2/Prednisone; 54910-89-3/Fluoxetine; 564-25-0/Doxycycline; 58-93-5/Hydrochlorothiazide; 80-08-0/Dapsone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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