Introduction
Demographics
Causes
Clinical features
Complications
Diagnosis
Differential diagnoses
Treatment
Morbihan disease was first described in 1957 by French dermatologist Robert Degos, and is characterised by a firm oedema on the upper portion of the face. Although generally considered as a refractory and chronic form of rosacea, Morbihan disease may exist in the absence of other features of rosacea, and thus may represent a separate disease process.
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Morbihan disease usually affects Caucasians in the third and fourth decade of life.
There are only two reports of the disease in skin of colour [1]. It is more common in women than men.
The lymphoedema of Morbihan disease follows the loss of lymphatic vessel wall integrity and the passing of fluid through the vessel. [2,3] The cause is unknown, but possible causes have been speculated, such as:
Morbihan disease is characterised by erythema and solid, non-pitting oedema.
Persistent facial oedema leads to:
There are no biochemical or histopathological findings specific to Morbihan disease.
Biopsy should be conducted to rule out other diagnoses. Nonspecific histopathology findings include:
Patch testing may also be arranged to exclude allergic contact dermatitis.
Differential diagnosis for Morbihan disease includes other granulomatous and inflammatory facial conditions [7,8]. Conditions to consider include:
Morbihan disease is frequently refractory to treatment.
The antibiotic metronidazole and the tetracyclines, minocycline and doxycycline, are effective for inflammatory rosacea. Other options are:
Thalidomide, clofazimine and systemic corticosteroids, such as prednisone, are typically ineffective.
Surgical excision of redundant oedematous tissue may be required for a full recovery. Other options are:
Facial massage can be used to improve lymphatic drainage. Contact irritants or allergens should be avoided to aid recovery.
