DERMATOLOGIC SOCIETY OF GREATER NEW YORK

Idiopathic(?) Periorbital Edema. Presented by Robert Auerbach, MD. A 58-year-old white woman (Fig 1) has had massive swelling of all eyelids for three months. Mild hyperpigmentation developed, but there has been no pruritus or other symptoms. Physical examination findings, history, and results of laboratory studies have revealed no evidence of renal, cardiac, or muscle disease, or of an internal malignant condition. Patch tests to substances found in topically applied medications, sprays, and paint were negative. A biopsy specimen from the left lower eyelid showed a normal epidermis for this site. The dermal connective tissue was pale-staining, with thin, widely separated connective tissue fibers. Melanophages were observed in the upper section of the corium. Inflammatory infiltrate was minimal; granulomas were not seen. The picture was interpreted as that of nonspecific edema, without evidence of substantial inflammatory response (Dr. Lewis Shapiro). Discussion Dr. Josef E. Jelinek: Has hypothyroidism been ruled out? Dr.