Ascher syndrome is a rare disorder classically characterized by blepharochalasis, double lip, and non-toxic thyroid goiter. We report a case initially diagnosed as eczema in the dermatology department, who presented with acquired double lips and blepharochalasis of the upper eyelids, without thyroid enlargement. Magnetic resonance imaging revealed uniformly increased T2-weighted signals in both the upper and lower lips, leading to a diagnosis of incomplete Ascher's syndrome. The patient underwent oculoplastic surgery, which successfully restored the natural aesthetic contour, demonstrating the efficacy and necessity of surgical intervention. We summarize the differential diagnosis of conditions related to Ascher's syndrome and analyze histopathological changes in the excised eyelid tissue to elucidate microscopic alterations associated with the disease.

Ascher syndrome is a rare, benign disorder typically identified by the triad of blepharochalasis, double upper lip, and occasionally non-toxic thyroid enlargement. Due to the variable presence and often isolated manifestation of its components, the diagnosis may be delayed or overlooked. In this report, we describe the case of a 31-year-old woman with a prominent double upper lip and bilateral upper eyelid laxity, the latter developing over years as a result of recurrent painless eyelid edema beginning in childhood. Clinical evaluation confirmed characteristic blepharochalasis and mucosal redundancy of the upper lip, with normal thyroid function and ultrasonographic findings limited to small asymptomatic nodules. Histopathologic examination of the excised eyelid tissue demonstrated hyalinized, acellular fibrous nodulation without neoplastic features, consistent with chronic post-edematous changes. The patient underwent successful upper eyelid blepharoplasty, achieving a favorable cosmetic result. This case emphasizes the importance of recognizing the constellation of findings suggestive of Ascher syndrome, even in the absence of overt thyroid involvement. Awareness of this rare condition allows for timely diagnosis and appropriate surgical planning, which are crucial for optimizing both functional and aesthetic outcomes.

Ascher syndrome is a rare disorder characterized by a triad of upper eyelid ptosis, lip mucosa hypertrophy, and nontoxic thyroid enlargement. Pediatric cases are extremely rare and often underrecognized due to nonspecific symptoms and the lack of standardized diagnostic criteria. We report the case of an 8-year-old boy with incomplete Ascher syndrome who presented with progressive bilateral upper eyelid laxity and thickened, everted lip mucosa. After comprehensive evaluation, surgical correction was planned to address the functional and cosmetic concerns associated with the lip deformity. The patient underwent mucosal excision with a double inverted "W" incision for the upper lip and a horizontal dumbbell-shaped incision for the lower lip. Histopathologic examination revealed characteristic findings, including salivary gland hyperplasia, edema, and reduced elastic fibers. No eyelid surgery was performed due to the absence of visual obstruction. Postoperative follow-up for 3 years demonstrated stable aesthetic results, normal lip function, and no recurrence or visible scarring. This case underscores the importance of early recognition and multidisciplinary planning in pediatric Ascher syndrome. Tailored surgical intervention can yield favorable long-term outcomes, even in young patients. A concise review of the literature is provided to contextualize this rare condition and to inform treatment strategies. Despite limited case volume, this report contributed to the growing clinical understanding of pediatric Ascher syndrome and highlighted the potential of personalized surgical approaches to optimize patient outcomes.

Laffer-Ascher syndrome is characterized by double lips, blepharochalasis, and nongoiter thyroid enlargement. The syndrome was first described in 1923 and several case reports have been published thereafter. We illustrate the syndrome through a case of a 46-year-old woman who presented with both upper and lower double lips and blepharochalasis, and review the literature published. Thyroid involvement is the most inconsistent feature of the syndrome complex described in reported cases.