Complex Decongestive Therapy in the Physical Therapist Management of Rosacea-Related Edema (Morbus Morbihan Syndrome): A Case Report with a New Approach

Abstract

Abstract Objective: The aim of this case report was to describe the use of complete decongestive therapy (CDT) with a new approach in the management of a male patient with facial edema related to Morbus Morbihan Syndrome (MMS). Methods: An 18-year-old male patient with MMS after acne treatment was the subject of this case report. Volume assessment was performed with distance measurements of the facial area using standard reference points, the overflow method, and the measurement of the percentage of subdermal fluid. Patient-reported symptoms of lymphedema (feeling of swelling and tightness) and body image perception were evaluated with the “Visual Analogue Scale (VAS)”, and the severity of anxiety was evaluated with the “State and Trait Anxiety Inventory (STAI)”. In addition, the patient’s perception of improvement was determined using a Likert-type scale. Evaluations were performed at baseline, week-4 (during the treatment) and week-8 (immediately after treatment). CDT was applied to the patient in a total of 24 sessions, 3 days a week for 8 weeks. Results: Compared to the baseline measurement, the facial distances (tragus-mental cavity, tragus-mouth corner, mandibula-nasal canal, mandibula-internal orbita, mandibula-external orbita, mental cavity-internal orbita, mental cavity-mandibula, right–left tragus, and hairline in the forehead-mental cavity), the volume and the percentage of subdermal fluid of facial area were found to be decreased at the 4th and 8th week measurements. The anxiety score, patient reports of feelings of swelling and tightness, and body image perception improved after the 8-weeks of treatment compared to baseline. Conclusion: This case report described the use of CDT in treating edema and patient symptoms in a patient with facial lymphedema related to MMS. Body image and level of anxiety improved.