Author: Brian Wu PhD. MD Candidate, Keck School of Medicine, Los Angeles, USA; Chief Editor: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, February 2016.
Ascher syndrome is characterised by persistent swelling of the lip and eyelids, and sometimes by nontoxic thyroid enlargement.
It was first described in 1920 by Dr. Ascher, an ophthalmologist in Prague. It is also sometimes called blepharochalasis and double lip.
Who gets Ascher syndrome?
Ascher syndrome is rare. It appears to have no prevalence by sex, age, sex or geographical area.
What causes Ascher syndrome?
The exact cause of Ascher syndrome is unknown. If acquired, swelling of the lips and eyelids is usually due to trauma. If congenital, it stems from some developmental anomaly.
Double lip deformity is due to persistence of horizontal sulcus with hypertrophy of the pars villosa.
Eyelid oedema is associated with a decrease in dermalelastin.
What are the clinical features of Ascher syndrome?
The three salient characteristics of Ascher syndrome include:
Blepharochalasis, or recurrent non-pitting, painless oedema of the eyelids in 80%
Lip deformity/double lip malformation due to folding of the oral mucosa. The upper lip is more often affected than the lower lip
Thyroid gland enlargement/goitre, in 10–50%
Staging of blepharochalasis is as follows:
Stage 1: Intermittent, painless oedema
Stage 2: Ptosis due to dehiscence of levatur aponeurosis
Stage 3: Ptosis adiposa, characterized by medial fat pad atrophy, orbital fat prolapse and lacrimal gland prolapse
Associated signs and symptoms of this condition include:
Treatment for Ascher syndrome can include surgery:
To correct double lip if it interferes with speaking, eating or for aesthetic reasons
To correct visual acuity disturbances or ocular complications
What is the outcome of Ascher syndrome?
With surgical treatment, prognosis is good and functional and aesthetic improvement can be achieved.
References
de Andrade-Santos, P.P. et. al. Double Lip Surgical Correction in Ascher’s Syndrome: Diagnosis and Treatment of a Rare Condition. Clinics. 2008. 63(5) 709–18. PubMed.
Ganesan, A. and Gautham, K. Ascher Syndrome: an Oral Medicine Perspective. International Journal of Dental Sciences and Research. 2014 2(4) 87–91.
Ramesh, B.A. Ascher Syndrome: A Review of Literature and Case Report. Indian Journal of Plastic Surgery. 2011. 44(1) 147–9. PubMed.
Schivcharan, L.C. Ascher’s Syndrome: a Rare Case Report. Indian Journal of Ophthalmology. 2015. 63(3) 264–7. PubMed.
