Anuradha Ganesan^1,, Gautham Kumar N²

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