Efficacité des diurétiques dans la prise en charge thérapeutique de la maladie de Morbihan : trois cas

Abstract

Morbihan's disease (MD), also known as 'persistent facial oedema' or 'rosaceous lymphoedema', is an uncommon facial condition that is difficult to treat. Its cause remains unclear. We report three new cases of solid persistent facial oedema, which, after treatment with furosemide, showed dramatic improvement. Three men (respectively aged 38, 66 and 76 years) presented Morbihan's disease progressing respectively for 2, 5 and 8 years. These patients presented with facial oedema, mainly affecting the eyelids. The diagnosis of MD was based on clinical and laboratory criteria (after exclusion of other aetiologies such as sarcoidosis, lupus erythematosus, facial demodicidosis and rosacea). After several unsuccessful treatments (tetracyclines, synthetic antimalarials, danazol, systemic steroids and isotretinoin), the patients received diuretics: furosemide (60 mg/d) in two cases and spironolactone 75 mg twice daily for the third patient. The patients were evaluated after 1 month, then every 3 months. Regression of oedema was complete or almost complete with follow-up of between 1 and 16 years. No adverse effects were reported. Treatment of Morbihan's disease remains difficult and empirical. Diuretics may be of value since they help significantly reduce swelling even if they do not definitely cure patients.