scholarly journals Peripheral Ulcerative Keratitis with Pyoderma Gangrenosum

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Adrián Imbernón-Moya ◽  
Elena Vargas-Laguna ◽  
Antonio Aguilar ◽  
Miguel Ángel Gallego ◽  
Claudia Vergara ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pyoderma Gangrenosum ◽  
Early Recognition ◽  
Skin Lesions ◽  
Unusual Event ◽  
Peripheral Ulcerative Keratitis ◽  
Appropriate Treatment ◽  
Autoimmune Conditions ◽  
Ulcerative Keratitis ◽  
Peripheral Cornea

Pyoderma gangrenosum is an unusual necrotizing noninfective and ulcerative skin disease whose cause is unknown. Ophthalmic involvement in pyoderma gangrenosum is an unusual event. Only a few cases have been reported, from which we can highlight scleral, corneal, and orbital cases. Peripheral ulcerative keratitis is a process which destroys the peripheral cornea. Its cause is still unknown although it is often associated with autoimmune conditions. Pyoderma gangrenosum should be included in the differential diagnosis of peripheral ulcerative keratitis. Early recognition of these manifestations can vary the prognosis by applying the appropriate treatment. We introduce a 70-year-old woman who suffered pyoderma gangrenosum associated with peripheral ulcerative keratitis in her left eye. The patient’s skin lesions and peripheral keratitis responded successfully to systemic steroids and cyclosporine A.

scholarly journals Peripheral ulcerative keratitis: A review of aetiology and management

2022 ◽  
Vol 81 (1) ◽  
Author(s):  
Roland Hӧllhumer
Keyword(s):  
Disease Control ◽  
Inflammatory Disease ◽  
Systemic Vasculitis ◽  
Management Approach ◽  
Peripheral Ulcerative Keratitis ◽  
Autoimmune Conditions ◽  
Pubmed Search ◽  
Acting Agent ◽  
Ulcerative Keratitis ◽  
Peripheral Cornea

Background: Peripheral ulcerative keratitis (PUK) is a severe inflammatory disease of the peripheral cornea that can be caused by local factors or systemic inflammatory disease.Aim: The purpose of this review is to give an overview of the pathophysiology, aetiology, clinical features, diagnosis, and management of PUK.Method: A PubMed search was conducted using the keywords, ‘peripheral ulcerative keratitis’ and ‘Mooren’s ulcer’.Results: The peripheral cornea has unique characteristics the predispose to the development of PUK. These include fine capillary arcades that allow for deposition of immune complexes and subsequent activation of an inflammatory cascade with corneal melt. Several conditions have been implicated in the aetiology of PUK. The most commonly cited causes are rheumatoid arthritis (RA), granulomatosis with polyangiitis (GPA) and various dermatoses. In patients with RA, PUK usually presents in established disease, whereas in GPA, PUK may be the presenting feature in up to 60% of cases. In RA it heralds the onset of a systemic vasculitis with significant associated morbidity and mortality. The management of PUK follows an individualised stepwise approach. All patients require supportive measures to encourage healing and halt the process of keratolysis. Systemic autoimmune conditions need a systemic corticosteroid as a fast-acting agent to halt the inflammatory process while cytotoxic therapy maintains long term disease control. Failure to achieve disease control with CTT, necessitates the use of a biologic agent.Conclusion: Peripheral ulcerative keratitis is a severe inflammatory disease of the peripheral cornea that needs a thorough diagnostic workup and stepwise management approach.

Bilateral Peripheral Ulcerative Keratitis Associated with Pyoderma Gangrenosum

Cornea ◽  
1997 ◽  
Vol 16 (4) ◽  
pp. 480???482 ◽  
Author(s):  
Charles S. Bouchard ◽  
Marcus A. Meyer ◽  
James F. McDonnell
Keyword(s):  
Pyoderma Gangrenosum ◽  
Peripheral Ulcerative Keratitis ◽  
Ulcerative Keratitis

scholarly journals Pyoderma Gangrenosum-like ulceration as a presenting feature of pediatric Granulomatosis with Polyangiitis

2020 ◽  
Author(s):  
Rotem Semo Oz ◽  
Oluwakemi Onajin ◽  
Liora Harel ◽  
Rotem Tal ◽  
Tomas Dallos ◽  
...  
Keyword(s):  
Pyoderma Gangrenosum ◽  
Granulomatosis With Polyangiitis ◽  
Skin Lesions ◽  
Response To Treatment ◽  
Newly Diagnosed ◽  
Rare Presentation ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
The Mean ◽  
Systemic Symptoms

Abstract Background: Granulomatosis with polyangiitis (GPA) is an anti-neutrophilic cytoplasmic antibody-associated vasculitis affecting small to medium-sized vessels and involves most commonly the kidneys and the respiratory tract. Skin involvement can be seen in up to 50% of children with GPA and is the initial presenting symptom in 7.7%. Pyoderma gangrenosum (PG)-like ulcers are rarely described as a skin manifestation in GPA and very few cases have been reported previously in children. Case presentation: We describe 3 new pediatric cases of GPA with PG-like ulcerations. The mean age at first symptom was 15 years. Two patients had PG-like ulceration as their initial presentation; additional symptoms eventually led to the diagnosis of GPA 2-24 months later. In 1 case, proteinase 3 (PR3) was negative when first tested, but converted to positive when systemic symptoms emerged, in the other 2 cases PR3 was positive at presentation. All 3 patients had prominent facial lesions. None of the patients responded to treatment with antibiotics or medications commonly used to manage PG, including corticosteroids and cyclosporine. All patients had excellent responses to rituximab. An electronic database literature review was performed and 4 previously reported cases were identified. We assessed the clinical characteristics, serology, and response to treatment of 4 previously reported and newly diagnosed cases. Conclusion: PG-like ulceration is a rare presentation of pediatric GPA which may precede classic systemic GPA symptoms. The predominance of facial ulcer, granulomatous and neutrophilic inflammation on skin biopsy and lack of response to PG treatments are characteristic of GPA-associated PG-like ulcers. Our review suggests that treatment with rituximab may be needed to improve the skin lesions. Recognizing that PG-like ulcerations can occur in pediatric GPA may result in timely diagnosis, appropriate treatment and improved prognosis.

scholarly journals The Horse Gallops But So Does the Zebra! A Case Report: Peripheral Ulcerative Keratitis

2020 ◽  
Author(s):  
sarah belghmaidi ◽  
soumia belgadi ◽  
ibtissam Hajji ◽  
abdeljalil Moutaouakil
Keyword(s):  
Case Report ◽  
Corneal Ulcer ◽  
Tear Film ◽  
Skin Lesions ◽  
Collaborative Management ◽  
Test Results ◽  
Schirmer Test ◽  
Peripheral Ulcerative Keratitis ◽  
Ulcerative Keratitis ◽  
Corneal Thinning

Abstract Introduction: Peripheral ulcerative keratitis (PUK) is an aggressive, potentially sight-threatening cause for peripheral corneal thinningCase report: A 43-year-old woman presented with bilateral tearing and ocular pain persisting for 7 months. Visual acuity was 6/6 in both eyes. On biomicroscopic examination, presence of crescent shaped corneal ulcer with perilesional haziness. A tear film study demonstrated decreased Schirmer test results (5mm in both eyes) and tear film break-up time (5 sec in both eyes). The interrogation and the patient revealed he had recurrent skin lesions in both legs with chronic itching, and recurrent oral and genital ulcers healing spontaneously. The diagnosis of behcet disease was proposed.Conclusion: Collaborative management of ophthalmic patients having systemic illness along with internists improves overall outcomes and prevents morbidity in such patients.

scholarly journals A 62-year-old man with new-onset bullae

2021 ◽  
Vol 42 (2) ◽  
pp. 175-179
Author(s):  
August J. Generoso ◽  
Jordana A. Goldman ◽  
Alan H. Wolff
Keyword(s):  
Differential Diagnosis ◽  
Lower Extremity ◽  
Physical Examination ◽  
Antibiotic Treatment ◽  
Drug Hypersensitivity ◽  
Genetic Diseases ◽  
Skin Lesions ◽  
Autoimmune Disorders ◽  
Autoimmune Conditions ◽  
New Onset

Cutaneous blisters and/or bullae can occur in autoimmune disorders, infections, genetic diseases, and drug hypersensitivity. We present the case of a 62-year-old man with two autoimmune conditions who was admitted for antibiotic treatment of a lower extremity infection and suddenly developed a bullous rash. His physical examination was significant for tense, bullous lesions that involved his chin, palms, and inner thighs. Narrowing the differential diagnosis for patients with blistering skin lesions is imperative for timely and appropriate management.

scholarly journals Pyoderma gangrenosum-like ulceration as a presenting feature of pediatric granulomatosis with polyangiitis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Rotem Semo Oz ◽  
Oluwakemi Onajin ◽  
Liora Harel ◽  
Rotem Tal ◽  
Tomas Dallos ◽  
...  
Keyword(s):  
Pyoderma Gangrenosum ◽  
Granulomatosis With Polyangiitis ◽  
Skin Lesions ◽  
Response To Treatment ◽  
Proteinase 3 ◽  
Newly Diagnosed ◽  
Rare Presentation ◽  
Case Presentation ◽  
Appropriate Treatment ◽  
Systemic Symptoms

Abstract Background Granulomatosis with polyangiitis (GPA) is an anti-neutrophilic cytoplasmic antibody-associated vasculitis affecting small to medium-sized vessels and involves most commonly the kidneys and the respiratory tract. Skin involvement can be seen in up to 50% of children with GPA and is the initial presenting symptom in 7.7%. Pyoderma gangrenosum (PG)-like ulcers are rarely described as a skin manifestation in GPA and very few cases have been reported previously in children. Case presentation We describe 3 new pediatric cases of GPA with PG-like ulcerations. The median age at first symptom was 15 years. Two patients had PG-like ulceration as their initial presentation; additional symptoms eventually led to the diagnosis of GPA 2–24 months later. In 1 case, proteinase 3 (PR3) was negative when first tested, but converted to positive when systemic symptoms emerged; in the other 2 cases PR3 was positive at presentation. All 3 patients had prominent facial lesions. None of the patients responded to treatment with antibiotics or medications commonly used to manage PG, including corticosteroids and cyclosporine. All patients had excellent responses to rituximab. An electronic database literature review was performed and 4 previously reported cases were identified. We assessed the clinical characteristics, serology, and response to treatment of the previously reported and our newly diagnosed cases. Conclusion PG-like ulceration is a rare presentation of pediatric GPA which may precede classic systemic GPA symptoms. The predominance of facial ulcer, granulomatous and neutrophilic inflammation on skin biopsy and lack of response to PG treatments are characteristic of GPA-associated PG-like ulcers. Our review suggests that treatment with rituximab may be needed to improve the skin lesions. Recognizing that PG-like ulcerations can occur in pediatric GPA may result in timely diagnosis, appropriate treatment and improved prognosis.

scholarly journals Erythema nodosum in a child with Salmonella Enteritidis infection

2021 ◽  
Vol 17 (2) ◽  
pp. 168-172
Author(s):  
Aleksandra Kamińska-Sobczak ◽  
◽  
Ewelina Karska ◽  
Agata Lange ◽  
Dorota Kardas-Sobantka ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Medical History ◽  
General Practitioners ◽  
Salmonella Enteritidis ◽  
Erythema Nodosum ◽  
Paediatric Population ◽  
Skin Lesions ◽  
Basic Information ◽  
Subcutaneous Nodules ◽  
Appropriate Treatment

The paper discusses a case of erythema nodosum in an almost 2-year-old boy diagnosed for fever and skin lesions on the extensor parts of the lower legs. Extended medical history and diagnosis allowed to identify Salmonella Enteritidis as the culprit of symptoms. This entity is rarely found in the paediatric population, especially in children <2 years of age. It clinically manifests with small, painful, red to purple subcutaneous nodules, mostly developing in the lower extremities. Only few cases of correlation between erythema nodosum and this serotype of Salmonella have been described in the available literature. Reminding general practitioners and paediatricians of the basic information about the possible course of the disease will allow for earlier differential diagnosis and more rapid and appropriate treatment.

Peripheral ulcerative keratitis

2021 ◽  
Author(s):  
Yogita Gupta ◽  
Alisha Kishore ◽  
Pooja Kumari ◽  
Neelima Balakrishnan ◽  
Neiwete Lomi ◽  
...  
Keyword(s):  
Peripheral Ulcerative Keratitis ◽  
Ulcerative Keratitis
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