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Persistent Periorbital and Facial Lymphedema Associated With Group A β-Hemolytic Streptococcal Infection (Erysipelas)

Buckland, Golden T. III M.D.*; Carlson, J Andrew M.D., F.R.C.P.C.; Meyer, Dale R. M.D., F.A.C.S.*

Ophthalmic Plastic & Reconstructive Surgery: March-April 2007 - Volume 23 - Issue 2 - p 161-163
doi: 10.1097/01.iop.0000256161.79015.38
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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.

Address correspondence and reprint requests to Golden T. Buckland III, M.D., Lion's Eye Institute, Suite 302, 1220 New Scotland Avenue, Albany (Slingerlands), NY 12159. E-mail: gtb@freekfly.com

©2007The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.