A Case of Melkersson-Rosenthal Syndrome Combined with Incomplete Tolosa-Hunt Syndrome.

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A case of Melkersson-Rosenthal syndromecombined with Tolosa-Hunt syndrome isreported. A 73-year-old woman had developedsudden swelling of the upper lip, linguaplicata, facial palsy, abducens paralysis andoculomotor nerve paralysis. Histological examination of the swollen lip shows markededema and perivascular lymphohistiocytein filtrations in the upper dermis. Small focal granulomatous cells, mainly composed of epithelioid cells, in filtrates in the deep dermisand subcutaneous tissue. On immunohistochemical examinations of the granulomatous cell infiltrates using anti-KP1 antibody, positive reactions were observed in the epithelioid cellsand the small portion of nerve-fibers which intermingled with the epithelioid cells.<BR>Patient was treated initially with corticosteroidper os for about one month. Afterthe therapy, there was considerable improvement of the skin lesion and the paralysis; however, swelling of the lip continued withsome frequency. Intramascular administration of Maruyama vaccine was then initiated andcontinued for 3 months, at intervals of 3 times a week, resulting in a resolution of allclinical symptomes except for abducens paralysis.
日本皮膚科学会大阪地方会の論文