International Journal of Dental Sciences and Research
ISSN (Print): 2333-1135 ISSN (Online): 2333-1259 Website: Editor-in-chief: Marcos Roberto Tovani Palone
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International Journal of Dental Sciences and Research. 2014, 2(4), 87-91
DOI: 10.12691/ijdsr-2-4-4
Open AccessCase Report

Ascher’s Syndrome - An Oral Medicine Perspective

Anuradha Ganesan1, and Gautham Kumar N2

1Department of Oral Medicine & Radiology, Madha Dental College & Hospital, Chennai, India

2Department of Periodontics, Madha Dental College & Hospital, Chennai, India

Pub. Date: July 02, 2014

Cite this paper:
Anuradha Ganesan and Gautham Kumar N. Ascher’s Syndrome - An Oral Medicine Perspective. International Journal of Dental Sciences and Research. 2014; 2(4):87-91. doi: 10.12691/ijdsr-2-4-4


Aim: The aim of this case report is to highlight an extremely rare syndrome with oral manifestations from an oral medicine perspective. Background: Ascher’s syndrome is an infrequent disease initially described by Ascher, an ophthalmologist, characterized by three more or less consistently associated abnormalities- double lip, blepharochalasis and enlargement of thyroid gland. This syndrome can be often missed out because of its rarity. Double lip is mostly seen in the upper lip and is also referred as macrocheilia. Blepharochalesis is localized angioedema of the eyelids. Thyroid enlargement is variable and not considered essential for the diagnosis of Ascher’s syndrome. Double lip is of special interest to the dental profession as dentists may be the first clinician to encounter patients with this anomaly. Case description: An apparently healthy 14 year old female reported with the chief complaint of excessive tissue in relation to upper lip, which interfered with her mastication. Clinical examination revealed a cupid bow shaped soft tissue overgrowth in the mucosal part of the upper lip which compromised her esthetics and function. The finding of blepharochalesis associated with her right upper eyelid led to the diagnosis of Ascher’s syndrome. Surgical correction of the excess lip tissue was done which considerably improved the appearance and function. Clinical significance: Detection of Ascher’s syndrome can be missed out because of its rarity. Even though the patient may primarily have only an esthetic complaint when he/she presents with a double lip, the dentist may usually be at the forefront to diagnose this syndrome and initiate appropriate referrals and management.

double lip Ascher’s syndrome blepharochalesis thyroid enlargement

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[1]  Pedo Paulo de Andrade Santos et al. Double lip surgical correction in Ascher’s syndrome: Diagnosis and treatment of a rare condition. Clinics 2008; Oct 63 (5): 709-712.
[2]  Beinhoffer, Piza katzer. Double lip in a patient with Ascher’s syndrome. Eur J plast Surg 1998; 2: 310-313.
[3]  Ali K. Ascher’s syndrome- a case report and review of literature. Oral Surg Oral Med Oral Pathol 2007; 103: 26-28.
[4]  Beena Roopak, Rohit. Congenital double lip – review of literature and case report. Ind J Clin Dent Jan 2012; 3 (1).
[5]  Martins W D, Westphales F H, Sandrin R et al. Congenital maxillary double upper lip: review of literature and report of a case. J Can Dent Assoc 2004; 70: 466-468.
[6]  Palma M C, Taub D I. Recurrent double lip: literature, review and report of case. Oral Surg Oral Med Oral Pathol Oral radiolog. Endod 107(2009), e 20-e 23.
[7]  Usha Dabas, Vipin. K. Dabas. Clinical relevance,verification of systemic connection and management. Report of two cases of maxillary and mandibular double lip. Indian Journal of Dentistry 4(2013); 114-118.
[8]  James, William, Berger et al. Andrews disease of skin. Clinical Dermatology (10 th edition) Saunders (2005); 515.
[9]  Suliman M.T, Al Hassan M Double lip: Report of five cases and review of literature. Aesthetic surgery Journal 2007: 27: 289-91.
[10]  Eski. M, Nisanci M, Aktas A et al. Congenital double lip: review of five cases. British journal and Maxillofacial Surgery 2007; 45: 68-70.
[11]  Braakenburg A et al. Bilateral eyelid edema: cutis lassa or blepharochalasis. Ann Plast Surg 2000 Nov: 45(5): 538-40.
[12]  Gomez-Duaso, Seane A J et al. Ascher’s syndrome: report of 2 cases. J Oral Maxillo fac surg.1997; 55: 88-90.
[13]  Kenny K F, Hreba J P, Dent C D. Bilateral redundant mucosal tissue of the upper lip. J Am Dent assoc 1990; 120(2): 193-4.
[14]  Gorlin R J, Pindborg, Cohen J J et al. Syndromes of the head and neck. Mc Graw-Hill NewYork (2nd edition) 1976. pp 253-255.
[15]  John Spencer M, Daniel, Congenital double upper lip: A case report and review of the literature. The Saudi Dental Journal (2010) 22, 101-106.
[16]  Ramesh B A. Ascher’s syndrome: review of literature and case report. Ind J Plastic Surg 2011; Jan-Apr 44 (1): 147-149.
[17]  Daphna M K, Sara PM et al. The blepharochalasis syndrome. Survey of ophthalmology Mar2009; 54: 235-244.
[18]  Sonia Goyal, Suhas Godhi, Sandeep Goyal: Non Syndromic Congenital Maxillary Double lip:a rare case. Journal oral health comm Dent 2008 2 (1): 10-12.
[19]  Dinesh Singh Chauhan, Yadavalli Guru Prasad. Congenital Maxillary Double Lip Chronicles of young scientists Vol3 Issue4 Oct-Dec 2012.
[20]  Cohen D N, Green J G et al. Current anomalies: cheilitis glandularis and double lip. Oral Surg Oral Med Oral Path 1988; 66: 397-9.
[21]  Costa Hanemann J A, Tostes- Oliveira D et al. Congenital double lip associated to hemangiomas: report of a case. Med Oral. 2004; 9: 155-158.
[22]  Atzeni M, Cerevola E, Zaccheddu F et al. Surgical correction and M R imaging of double lip in Ascher’s syndrome: record of a case and review of literature. Eur Rev Med Pharmacol Sci2009; 13(4)-309-311.