Ocular manifestations of atopic dermatitis

Purpose: A review of the published literature on the history, pathogenesis, and treatment of atopic dermatitis (AD) and its ocular involvement. Methods: Literature searches were conducted in MEDLINE (Ovid) and Google scholar for AD and ocular AD. Results: AD is an inflammatory dermatosis that has classic presentations on the skin at different age points. The primary immunological profile is a Th2 profile, releasing an abundance of IL4 and IL10 both systemically and locally. AD can involve the eye and have devastating consequences. Here we review the latest understanding of AD pathogenesis and treatments vis-à-vis the ocular surface. Conclusion: Ocular AD is a common manifestation of AD. The newest drugs for systemic AD might be deleterious for ocular AD.

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Ocular surface manifestations of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0241661 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0241661 ◽

Cited By ~ 1

Author(s):

Kanika Aggarwal ◽

Aniruddha Agarwal ◽

Nishant Jaiswal ◽

Neha Dahiya ◽

Alka Ahuja ◽

...

Keyword(s):

Ocular Surface ◽

Meta Analysis ◽

Severe Pneumonia ◽

Viral Rna ◽

Ocular Involvement ◽

Ocular Pain ◽

Cross Sectional ◽

Pooled Data ◽

Ocular Manifestations ◽

Follicular Conjunctivitis

Purpose This study was performed to determine the occurrence of ocular surface manifestations in patients diagnosed with coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods A systematic search of electronic databases i.e. PubMed, Web of Science, CINAHL, OVID and Google scholar was performed using a comprehensive search strategy. The searches were current through 31st May 2020. Pooled data from cross-sectional studies was used for meta-analysis and a narrative synthesis was conducted for studies where a meta-analysis was not feasible. Results A total of 16 studies reporting 2347 confirmed COVID-19 cases were included. Pooled data showed that 11.64% of COVID-19 patients had ocular surface manifestations. Ocular pain (31.2%), discharge (19.2%), redness (10.8%), and follicular conjunctivitis (7.7%) were the main features. 6.9% patients with ocular manifestations had severe pneumonia. Viral RNA was detected from the ocular specimens in 3.5% patients. Conclusion The most common reported ocular presentations of COVID-19 included ocular pain, redness, discharge, and follicular conjunctivitis. A small proportion of patients had viral RNA in their conjunctival/tear samples. The available studies show significant publication bias and heterogeneity. Prospective studies with methodical collection and data reporting are needed for evaluation of ocular involvement in COVID-19.

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Atopic dermatitis

Allergy and Asthma Proceedings ◽

10.2500/aap.2019.40.4265 ◽

2019 ◽

Vol 40 (6) ◽

pp. 433-436 ◽

Cited By ~ 6

Author(s):

Neill Peters ◽

Anju T. Peters

Keyword(s):

Atopic Dermatitis ◽

Close Association ◽

Interferon Γ ◽

Topical Steroids ◽

T Helper ◽

Older Children ◽

Barrier Dysfunction ◽

Inflammatory Dermatosis ◽

Simplex Virus ◽

Helper Type

Atopic dermatitis (AD), also known as atopic eczema, is a chronic relapsing inflammatory dermatosis characterized by pruritus, xerosis, and a close association with IgE mediated sensitization to aeroallergens and foods. More than 60% of children with AD are at risk to develop allergic rhinitis or asthma (the atopic march). The distribution of lesions varies by age. Infants tend to have lesions on the cheeks and scalp, and very young children typically have involvement over the extremities, cheeks, forehead, and neck. A rash in the diaper area of infants is rarely AD. Lesions in older children and adults are usually located in flexural areas, such as the antecubital and popliteal fossae, along with the head and neck. Acute lesions of AD begin as erythematous papules and serous exudates. Secondary lesions include excoriations and crusted erosions due to scratching. Subacute lesions appear as erythematous scaling papules and plaques. If the itch and rash progress uncontrolled, then chronic lichenified AD develops, which features accentuated skin markings with hyperpigmentation. Trigger avoidance, skin hydration, and topical steroids are the first steps for improvement. In acute lesions of AD, the T-helper type 2 cells produce interleukin (IL) 4, IL-13, and IL-31, which may potentiate barrier dysfunction and contribute to pruritus. In chronic lesions, the T-helper type 1 cells predominate and secrete interferon γ and IL-12. Barrier dysfunction from filaggrin predisposes patients to AD. Skin superinfection, particularly with Staphylococcus aureus, is common, and cultures of affected lesions help guide therapy. Eczema herpeticum from herpes simplex virus can be life threatening in patients with AD.

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The clinical spectrum of ocular bartonellosis: a retrospective study at a tertiary centre in Malaysia

Journal of Ophthalmic Inflammation and Infection ◽

10.1186/s12348-020-00224-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Michele Shi-Ying Tey ◽

Gayathri Govindasamy ◽

Francesca Martina Vendargon

Keyword(s):

Hand Movement ◽

Clinical Findings ◽

Common Finding ◽

Final Visit ◽

Ocular Involvement ◽

Exudative Retinal Detachment ◽

Tertiary Centre ◽

Ocular Manifestations ◽

Ocular Findings ◽

Clinical Records

Abstract Background Cat scratch disease (CSD) is a systemic illness caused by the gram-negative bacillus, Bartonella henselea, which can occasionally involve the ocular structures. The objective of this study is to evaluate the various clinical presentations of ocular bartonellosis at our institution. A retrospective review of the clinical records of 13 patients (23 eyes) with ocular manifestations of Bartonella infections over a 3-year period between January 2016 to December 2018 was undertaken at our institution. Results The diagnosis was made based on clinical findings and in addition, with the support of the evidence of Bartonella hensalae IgG and/or IgM. Small retinal white lesions were the most common ocular findings in this series of patients (82.6% of eyes, 76.9% of patients). Neuroretinitis was the second most common finding (47.8% of eyes, 69.2% of patients), followed by exudative retinal detachment involving the macula (34.8% of eyes, 53.8% of patients) and Parinaud’s oculoglandular syndrome (17.4% of eyes, 23.1% of patients). Other findings like isolated optic disc oedema without macular star (8.7% of eyes, 15.4% of patients) and vitritis (4.3% of eyes, 7.7% of patients) were also observed. Ten patients (76.9%) had bilateral ocular involvement. Most of the patients were young, immunocompetent and had systemic symptoms like fever prior to their ocular symptoms. The visual acuity (VA) at initial presentation ranged from 6/6 to hand movement (mean, 6/20), and at final visit 6/6 to 6/60, (mean, 6/9). 91.7% of patients were treated with antibiotics. Only 2 patients received oral corticosteroids together with antibiotics due to very poor vision on presentation. The visual prognosis of ocular bartonellosis is generally good with 16 (88.9%) of 23 eyes having VA of 6/12 or better at final follow-up visit. Conclusion Small foci of retinal white lesions were the most common manifestation of ocular bartonellosis in this series, followed by neuroretinitis, though an array of other ocular findings may also occur. Therefore, we should consider bartonella infection as a possible differential diagnosis in those patients.

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Current concepts in the diagnosis and management of antiphospholipid syndrome and ocular manifestations

Journal of Ophthalmic Inflammation and Infection ◽

10.1186/s12348-021-00240-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Gunay Uludag ◽

Neil Onghanseng ◽

Anh N. T. Tran ◽

Muhammad Hassan ◽

Muhammad Sohail Halim ◽

...

Keyword(s):

Antiphospholipid Syndrome ◽

Antiphospholipid Antibodies ◽

Clinical Manifestations ◽

Autoimmune Disorder ◽

Ocular Involvement ◽

Ocular Manifestations ◽

Different Types ◽

Thrombotic Complications ◽

Specific Factors ◽

Arteries And Veins

AbstractAntiphospholipid syndrome (APS) is an autoimmune disorder associated with obstetrical complications, thrombotic complications involving both arteries and veins, and non-thrombotic manifestations affecting multiple other systems presenting in various clinical forms. Diagnosis requires the presence of antiphospholipid antibodies. The exact pathogenesis of APS is not fully known. However, it has recently been shown that activation of different types of cells by antiphospholipid antibodies plays an important role in thrombosis formation. Ocular involvement is one of the important clinical manifestations of APS and can vary in presentations. Therefore, as an ophthalmologist, it is crucial to be familiar with the ocular findings of APS to prevent further complications that can develop. Furthermore, the ongoing identification of new and specific factors contributing to the pathogenesis of APS may provide new therapeutic options in the management of the disease in the future.

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Ocular manifestations in Herpes Zoster Ophthalmicus

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v3i2.5271 ◽

1970 ◽

Vol 3 (2) ◽

pp. 165-171 ◽

Cited By ~ 16

Author(s):

LR Puri ◽

GB Shrestha ◽

DN Shah ◽

M Chaudhary ◽

A Thakar

Keyword(s):

Herpes Zoster ◽

Young Patients ◽

Ocular Involvement ◽

Post Herpetic Neuralgia ◽

Visual Disability ◽

Herpes Zoster Ophthalmicus ◽

Cross Sectional ◽

Ocular Manifestations ◽

Visual Status ◽

The Mean

Background: Ocular complications of herpes zoster ophthalmicus (HZO) may lead to substantial visual disability, severe post-herpetic neuralgia and rarely fatal cerebral complications. Aim: To identify the pattern of ocular manifestation in herpes zoster ophthalmicus. Materials and methods: A cross-sectional descriptive study was under taken including the clinically diagnosed cases of HZO. All of them underwent a complete ophthalmological evaluation. Results: Sixty-eight cases of HZO were examined, of which 37 (54.4 %) were male and 31 (45.6%) female. The mean age was 48.7 ± 18.5 years. Most of the patients (64.7 %) were above the age of 40 years. 77.94 % of the patients had some form of ocular involvement. Pain (77.9 %) was the commonest ocular complaint. In young patients less than 35 years, HIV was the most common risk factor (19.3 %).Visual status was good in the majority (73.5 %) of patients at presentation. Lid and adnexal findings (45.8 %) were most common ocular involvement followed by conjunctivitis (41.1 %). Corneal complication was seen in 38.2 % of cases, uveitis in 19.1 % and post-herpetic neuralgia (PHN) and secondary glaucoma each in 5.8 %. Conclusion: Eyelid and ocular adnexal involvement is most commonly found in patients with herpes zoster ophthalmicus followed by corneal complication and uveitis. There needs to be awareness of ocular involvement, which can be sight threatening, among the HZO patients and other medical departments and an increased emphasis on regular ophthalmic examination. Key words: herpes virus, herpes zoster, conjunctivitis, keratitis DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5271 Nepal J Ophthalmol 2011; 3(2): 165-171

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Eczematous Disorders, Atopic Dermatitis, and Ichthyoses

10.2310/tywc.1018 ◽

2018 ◽

Author(s):

Seth R Stevens

Keyword(s):

Atopic Dermatitis ◽

Differential Diagnosis ◽

Contact Dermatitis ◽

Seborrheic Dermatitis ◽

Inflammatory Dermatosis ◽

Poison Ivy ◽

Eczematous Dermatitis ◽

Total Body ◽

Allergic Contact ◽

Nummular Eczema

This review describes eczematous dermatitis, or eczema, a skin disease that is characterized by erythematous vesicular, weeping, and crusting patches; atopic dermatitis, a common chronic inflammatory dermatosis that generally begins in infancy; and the ichthyoses, a group of diseases of cornification that are characterized by excessive scaling. The purpose of this review is to examine the major variants, epidemiology, etiology, diagnosis, differential diagnosis, and treatment of these dermatologic diseases. Figures depict chronic eczematous dermatitis, allergic contact dermatitis to poison ivy, seborrheic dermatitis, nummular eczema, acute eczematous patches, lichenified patches that appear after chronic rubbing of eczematous patches, erythroderma (total body erythema), and marked scaling (acquired ichthyosis). Tables list the diagnostic criteria for atopic dermatitis and the differential diagnosis of atopic dermatitis. This review contains 9 highly rendered figures, 2 tables, and 88 references.

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Topical Ophthalmic Cyclosporine in the Treatment of Toxic Epidermal Necrolysis

Case Reports in Medicine ◽

10.1155/2011/416842 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3

Author(s):

Zafer Onaran ◽

Gülşah Usta ◽

Mukadder Koçak ◽

Kemal Örnek ◽

Ünase Büyükkoçak

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Toxic Epidermal Necrolysis ◽

Ocular Surface ◽

Acute Stage ◽

Ocular Involvement ◽

Pathologic Finding ◽

Ocular Complication ◽

Case Presentation ◽

Intravenous Corticosteroid

Aim. To describe a case of toxic epidermal necrolysis (TEN) with ocular involvement treated with topical ophthalmic cyclosporine.Case Presentation. A 20-year-old woman developed TEN following administration of carbamazepine that was prescribed for epilepsy. Ophthalmic examination revealed bilateral pseudomembranous conjunctivitis. She was hospitalized in the intensive care unit and treated with intravenous corticosteroid and immunoglobulin. Topical cyclosporine was used in combination with topical corticosteroids for ocular surface disease. Following two months of ocular treatment, she recovered without any severe ocular complication. Ocular examination at the four-month followup showed a 2 mm of symblepharon in the lower fornix as the sole pathologic finding.Conclusion. Topical ophthalmic cyclosporine may contribute to decrease the ophthalmic complications of TEN and should be considered in the acute stage of the disease.

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A CASE OF DISSEMINATED TUBERCULOSIS WITH OCULAR INVOLVEMENT

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703875 ◽

2015 ◽

Vol 05 (01) ◽

pp. 094-096

Author(s):

Md Fekarul Islam ◽

Devdeep Mukherjee ◽

Ritabrata Kundu ◽

Prabal Chandra Niyogi ◽

Joydeep Das

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Corneal Opacity ◽

Ocular Involvement ◽

Disseminated Tuberculosis ◽

Ocular Manifestations ◽

The Central Nervous System ◽

Immunocompromised State ◽

Ocular Tb ◽

Posterior Synechiae

AbstractDisseminated Tuberculosis (DTB) refers to tubercular involvement of two or more non-contiguous sites and is commonly associated with immunocompromised state. It is an unusual presentation of Tuberculosis (TB), especially in the absence of immunodeficiency. 1.4% of patients with Pulmonary Tuberculosis (PTB) develop ocular manifestations but many patients with ocular TB have no evidence of PTB. Tuberculosis can cause a wide variety of ophthalmic findings, ranging from the ocular surface through the optic nerve and to the central nervous system. In this article, we report a case of Disseminated Tuberculosis with ocular involvement in a 5years old female. Our case is unique for the presence of bilateral squint, unilateral nebular type of corneal opacity, bilateral iritis with posterior synechiae and cataract at the same time. It lays emphasis on the fact that a patient with tuberculosis should be screened for multiple foci.

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What Do We Know about Pruritus in Very Young Infants? A Literature Review

Cells ◽

10.3390/cells10102788 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2788

Author(s):

Camille Le Pors ◽

Matthieu Talagas ◽

Claire Abasq-Thomas ◽

Séverine Henry ◽

Laurent Misery ◽

...

Keyword(s):

Atopic Dermatitis ◽

Literature Review ◽

Adverse Effects ◽

Negative Impact ◽

Vulnerable Population ◽

Google Scholar ◽

Skin Development ◽

Young Infants ◽

Chronic Pruritus

In infants, pruritus is frequently considered as absent because they do not scratch themselves. Because pruritus could induce severe adverse effects in this vulnerable population, we aimed to review existing evidence on the ability of young infants to experience itch and on how to assess itch-related discomfort in this population. A literature review was performed (Pubmed, Google Scholar). Neurological itch pathways are well described. Skin development starts early during gestation. At 34 weeks of gestation, skin is almost complete while skin adaptations occur after birth. Newborn skin is neurologically functional, including the ability for young infants to feel pain. Similarities and interactions between pain and pruritus support the hypothesis that infants could feel pruritus. However, the existence of pruritus in infants has never been evidenced. Many itchy conditions can affect them, suggesting non-negligible prevalence of infant pruritus among which atopic dermatitis (AD) is the most studied disease. Studies reported a negative impact of AD on children and their families. There is no existing validated method to assess pruritus in infants, although they may feel pruritus and chronic pruritus can lead to serious adverse effects. To appropriately diagnose pruritus appears of great interest among young infants. Development of a method is required to this aim.

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Lichen Planus as a Possible Rare Cause of an Ocular Disease

Czech and Slovak Ophthalmology ◽

10.31348/2019/4/6 ◽

2019 ◽

Vol 75 (4) ◽

pp. 219-223

Author(s):

Jana Nekolová ◽

Markéta Středová ◽

Miroslav Podhola ◽

Naďa Jirásková

Keyword(s):

Lichen Planus ◽

Inflammatory Disease ◽

Ocular Surface ◽

Negative Impact ◽

Rare Event ◽

Chronic Inflammatory Disease ◽

Mental Condition ◽

Unknown Etiology ◽

Ocular Involvement ◽

Irreversible Damage

Lichen planus is a relatively common mucocutaneous papulosquamous disorder of unknown etiology that is thought to be immunologically mediated. Ocular involvement of lichen planus (LP) is a rare event, which can lead to irreversible damage to the ocular surface and loss of vision from cicatrizing blepharoconjunctivitis and corneal scarring. Steroids are the first treatment choice. Treatment with topical ciclosporin A is also a possible treatment. We report a case of 79-year-old woman who was treated for long lasting severe inflammatory disease of a ocular surface. It led to blindness of one eye and low vision of the second eye. The diagnosis was made thanks to correlation of biopsy results from oral and ocular surface. The patient was also diagnosed with middle-stage dementia. Negative impact of steroid therapy on mental condition of this patient was considered. On the other hand, dementia could cause worse compliance with recommended treatment regime. Chronic inflammatory disease of ocular surface requires long lasting treatment very often and it is sometimes not as effective as expected. Discovering etiological causes of the disease is a priority for the right treatment. We emphasize also the key role of physical and mental condition in management of ocular surface disease.

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