Abstract
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.