■由中性粒细胞和免疫介导引起的小动脉疾病被称为白细胞碎裂性血管炎(LCV)。临床上,它表现为明显的,四肢无症状的紫癜性丘疹。眼部表现很少见。这里,我们描述了一例与LCV相关的外周溃疡性角膜炎(PUK)。
■一名59岁男子因左眼角膜穿孔视力模糊被转诊到医院。他抱怨他的手和小腿有15年的发痒结节,他的手背皮肤活检显示了6年前的LCV,提示直立性红斑。该患者正在接受抗炎和免疫抑制药物的治疗,并且在他身上看到的LCV的身体特征包括他的手和腿上的红斑。在接受结膜瓣覆盖手术后,角膜穿孔得到解决。结膜瓣覆盖角膜,这限制了他的视力。六个月后,他又因为疼痛被转诊到我们的诊所,发红,畏光,右眼撕裂,介绍PUK。手术期间切除了坏死组织,其中还包括结膜瓣覆盖程序。手术后,症状减轻了,术后眼部情况保持稳定。
■据我们所知,这是6年前诊断为LCV继发的第一例PUK。该病例表明与LCV相关的PUK可以通过手术干预成功治疗。
UNASSIGNED: Small artery disease caused by neutrophils and immune-mediated is known as leucocytoclastic vasculitis (LCV). Clinically, it manifests as palpable, asymptomatic purpuric papules on the limbs. Ocular manifestation is rare. Here, we describe a
case of peripheral ulcerative keratitis (PUK) associated with LCV.
UNASSIGNED: A 59-year-old man was referred to the hospital with blurred vision due to corneal perforation in his left eye. He complained of itchy nodules on his hands and lower legs for 15 years and the skin biopsy of the back of his hand revealed LCV 6 years ago, which suggested erythema elevatum diutinum. The patient was under treatment with anti-inflammatory and immunosuppressive drugs and physical features of LCV seen in him included erythema on his hands and legs. After receiving conjunctival flap covering surgery, the corneal perforation was resolved. Conjunctival flaps covered cornea that limited his vision to hand motion. Six months later, he was referred to our clinic again because of pain, redness, photophobia, and tearing in the right eye, presenting with PUK. Necrotic tissue was removed during surgery, which also included a conjunctival flap covering procedure. Following surgery, the symptoms were reduced, and the postoperative eye condition remained stable.
UNASSIGNED: To our knowledge, it is the first
case of PUK secondary to LCV which was diagnosed 6 years ago. This
case demonstrates that PUK associated with LCV can be successfully treated by surgical interventions.