Acne Rosacea With Keratitis in Childhood

Blepharokeratoconjunctivitis in childhood: corneal involvement and visual outcome

“…Intentional selection bias of patients included for analysis is also a great contributor for such a wide range of corneal manifestations in BKC, and so is the lack of wellestablished diagnostic criteria that clearly defines the disease. 1,4,5,11,17,18 In the present study, where all patients with BKC consecutively seen in our clinic during a 6-year period were included for analysis, and diagnostic criteria established by Gupta 1 and Doan 5 were applied to all patients, the prevalence of corneal involvement was 39.5%. This may represent a more accurate figure although it is also biased by the fact that our center is a tertiary care facility, and patients with a milder disease may had not attended our service.…”

“…1,3,6,11,17,18 This great variation may be due to differences in demographic, socioeconomic, and cultural characteristics of populations studied. Intentional selection bias of patients included for analysis is also a great contributor for such a wide range of corneal manifestations in BKC, and so is the lack of wellestablished diagnostic criteria that clearly defines the disease.…”

“…15 In this respect, we decided to implement a therapeutic protocol based on disease severity and level of corneal involvement. 10,11,[14][15][16]18 Lid hygiene and lubricant eye drops were the standard of care for all patients. 10,14 Warm compresses prior to lid massage and omega-3 supplementation were added to patients with MGD, history of chalazia and hordeolum.…”

“…Systemic erythromycin has been the antibiotic of choice in most published series of BKC in children, and was given to almost all our patients (88.8%) with corneal involvement. 2,3,5,10,15,17,18,39 Erythromycin can modulate the production of proinflammatory cytokines and neutrophil adhesion, among other anti-inflammatory effects. 10,39 Although gastrointestinal upset is a frequent side effect reported with this antibiotic, this is a rare problem at a lower dose, as shown in the present study where a dose as low as 125 mg every other day was sustained for 6.4 months in most patients treated.…”

Childhood stye and adult rosacea

“…The meibomian gland dysfunction and tear component alterations found in adult ocular rosacea often present with conjunctivitis, blepharitis, sties, and chalazia. 8,10 Fully developed rosacea and ocular rosacea are rare in childhood, 22,23 but sties, conjunctivitis, blepharitis, and chalazia are common in children from infancy on. If these eye findings in children have the same pathophysiologic basis as their counterparts in adults, children who present with these conditions might be at increased risk for development of rosacea as adults.…”