혈관부종으로 오인이 가능한 Morbihan 병 1예

Abstract

Morbihan disease is a rare condition characterized by persistent facial edema that is often misdiagnosed as angioedema due to similar clinical presentation. We report a case of a 76-year-old male presenting with periorbital edema and facial erythema unresponsive to conventional angioedema treatments including antihistamines and systemic corticosteroids. Despite the addition of cyclosporine, periorbital edema and facial erythema persisted for 2 months without improvement. Multidisciplinary evaluation revealed Morbihan disease associated with rosacea. The patient was successfully treated with isotretinoin (20 mg daily) and roxithromycin (300 mg daily) for 6 months, with significant improvement observed after 3 months of therapy. This case highlights the importance of considering Morbihan disease in the differential diagnosis of persistent facial edema unresponsive to conventional angioedema treatments. Unlike angioedema, Morbihan disease presents as nonpitting edema with gradual onset, chronic progression, and poor response to antihistamines and corticosteroids, which requires specific therapeutic approaches for effective management. When patients present with facial edema refractory to conventional angioedema treatment, clinicians should consider alternative diagnoses through a multidisciplinary approach, which facilitates accurate diagnosis and appropriate treatment selection for these challenging cases.