Morbihan Disease Treatment: Two Case Reports and a Systematic Literature Review. Issue 2 (March 2019)

• Record Type: Journal Article
• Authors: Boparai, Ranjodh S.; Levin, Ariana M.; Lelli, Gary J.
• Is Part Of: Ophthalmic plastic and reconstructive surgery. Volume 35:Issue 2(2019)
• Publication Date: 2019-03
• Subjects: Eye -- Surgery -- Periodicals; Ophthalmic plastic surgery -- Periodicals; Reconstructive Surgical Procedures -- Periodicals; Ophthalmologic Surgical Procedures -- Periodicals; Ophthalmology -- Periodicals; Surgery -- Periodicals; 617.70592
• DOI: 10.1097/IOP.0000000000001229
• Languages: English
• ISSNs: 0740-9303

Abstract

Abstract : Purpose: To assess the effectiveness of treatments for Morbihan disease. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the literature was performed on April 1, 2018, using PubMed, Google Scholar, and Excerpta Medica dataBASE with terms used to describe Morbihan disease, including "Morbihan Disease, " "Morbihan Syndrome, " "lymphedema rosacea, " and "lymphedematous rosacea". Case reports or case series were included if they fulfilled the following criteria: published in English, peer-reviewed, and reported Morbihan disease. Results: A total of 89 patients—87 patients from 49 articles and 2 cases from the authors' institution—were included in the final analysis. The median age of patients was 51 years (range: 14–79), and 66 of 89 (74%) patients were men. Male gender correlated with lack of complete response to treatment (odds ratio: 0.25; 95% confidence interval: 0.06–0.97; p = 0.02), while presence of papules or pustules correlated with complete response to treatment (odds ratio: 4.07; 95% confidence interval: 1.04–17.68; p = 0.03). Longer antibiotic duration correlated with response to treatment ( p = 0.03), favoring complete over partial response ( p = 0.02). Mean antibiotic duration in patients who responded was 4.43 months (standard deviation: 3.49), with complete responders requiring 6.50 months (standard deviation: 4.57). Oral corticosteroids, isotretinoins, and combination therapies did not correlate with treatment response. Conclusions: The presence of papules and pustules correlates with a complete response to treatment, while male gender correlates with a partial response. Patients may benefit from 4- to 6-month duration of tetracycline-based antibiotics. Prospective studies are needed to assess the impact of antibiotic and isotretinoin dose and duration on treatment response. Abstract : In this systematic review, 4- to 6-month duration of tetracycline-based antibiotics correlated with response to treatment, favoring complete over partial response. Other commonly used treatments, including oral corticosteroids, isotretinoins, and combination therapies did not correlate with treatment response.