Unilateral eyelid swelling in naevus flammeus faciei. Problems in differential diagnosis of unilateral eyelid swelling

A 32-year-old white woman presented with persistent swelling of the right upper eyelid for diagnosis and therapy. History and physical examination revealed a faint nevus flammeus on the right side of her face and neck and bilateral blepharochalasis, both of which can produce unilateral periorbital swelling. A biopsy taken for histology was diagnostic in this case, since it showed lymphoedema secondary to lymphangiectasias associated with the patient's port-wine stain. Many other possible causes of unilateral lid swelling have to be considered and excluded before a definite diagnosis can be established. The differential diagnosis is discussed.