36 | morbihan disease in a mauritian patient: A case report and review of the asian literature

Morbihan disease (MD) is a rare dermatological condition mainly affecting Caucasian patients with persistent facial edema. The cutaneous manifestations cause functional and aesthetic problems, preventing the patients from opening their eyes and disfiguring them. MD is refractory to many therapeutic regimens, and there is no established gold standard treatment. We describe the case of a Mauritian patient with MD and review the literature to examine the clinical features and treatment responses in Asian MD patients. Our case is noteworthy due to the rarity of the disease in Asia and the excellent response to the first-line therapy with oral isotretinoin. In our review, we identified 54 Asian patients with MD (37 males and 17 females). The eyelids were the most common site of persistent edema localization. Although most of the existing literature focuses on the Western populations, MD is probably underestimated in Asian individuals, potentially due to the difficulty in discerning erythema. Among the oral drugs, the best outcomes were achieved with both tetracycline-class antibiotics and isotretinoin. Among topical treatments, tacrolimus 0.1% ointment and ivermectin 1% cream were effective in half of the reported cases. Surgery seems to be the more aggressive but effective therapeutic option. Globally, the clinical-histological findings and treatment outcomes of Asian patients with MD did not differ significantly from those observed in Western patients. In conclusion, MD can be challenging to diagnose and treat and may require a range of topical and oral interventions. Dermatologists should consider the possibility of this rare diagnosis across all phototypes to avoid misdiagnoses and complications.