Chronic lymphedema is both a risk factor for and consequence of erysipelas (cellulitis). We report a case of a 62-year-old woman with rheumatoid arthritis treated with etanercept and prednisone, who developed chronic periorbital lymphedema 2 months after Group A β-hemolytic streptococcus infection of the face. She had significant ptosis OS and thickened, hyperpigmented periorbital skin. Biopsies were consistent with chronic lymphedema. Of note, on 6 months follow-up, the patient's appearance was improved though she still had residual ptosis. A period of extended observation may be warranted in these cases.
Periorbital Group A streptococcal infection in a moderately immunocompromised patient can lead to chronic lymphedematous changes and ptosis.
*Department of Ophthalmology; and †Pathology, Division of Dermatology and Dermatopathology, Albany Medical College, Albany, New York, U.S.A.
Accepted for publication September 20, 2006.
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