Duke-Elder1 described solid edema of lids or elephantiasis nostras as a generalized hypertrophy of the cutaneous and subcutaneous tissues of the lids following a chronic or recurrent inflammation with edema. The condition has not been commonly reported in the literature. The most usual cause is a chronic eczema or recurrent erysipelas. The lids appear swollen and edematous without inflammatory symptoms. On palpation the skin has a characteristic solid consistency into which the fingers can sink, but it cannot be pitted. Pathologically, the main gross changes are infiltrations of chronic inflammatory type extending throughout the dermis, the subcutaneous tissue, and orbicularis muscle. The blood vessels may show endothelial proliferation and obliteration with thrombosis. Sometimes lymphatic dilatation is present in the subcutaneous tissues.
The four cases to be described in this paper were diagnosed clinically as unilateral upper or lower lid chronic solid edema. Investigations done to find the cause were
MORTADA A. Benign Tumors of Lid Dermis Presenting as Solid EdemaUnilateral Upper or Lower Lid. Arch Ophthalmol. 1963;70(3):369-371. doi:10.1001/archopht.1963.00960050371017