Erythema elevatum diutinum associated with peripheral ulcerative keratitis

Vaiyavatjamai, Premjit; Wattanakrai, Penpun

doi:10.1111/j.1468-3083.2010.03761.x

Cited by 5 publications

(6 citation statements)

References 5 publications

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“…Comorbid malignancy occurred in 13 cases (9.77%); three case reports documented an association with lymphoma, two cases with IgA multiple myeloma, two cases with nonspecified multiple myeloma, and there were single cases associated with lung cancer, breast cancer, myelofibroblastic tumor, IgA‐MGUS, and myelodysplastic syndrome. Ocular involvement was reported in 10 cases (7.5%); the most common comorbid ophthalmologic finding was peripheral ulcerative keratitis, an association reported in six cases …”

Section: Resultsmentioning

confidence: 99%

Erythema elevatum diutinum: a case report and review of literature

Doktor¹,

Hadi

Phelps

et al. 2018

Int J Dermatology

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Erythema elevatum diutinum (EED) is a rare cutaneous leukocytoclastic vasculitis thought to be related to increased levels of circulating antibodies. It has been shown to be associated with HIV infection, tuberculosis, as well as various autoimmune diseases. A retrospective review of all cases of EED indexed in PubMed between 1990 and 2014 was performed. Inclusion criteria for articles was availability of full text in English and a biopsy-confirmed diagnosis of EED. All other articles were excluded. Cases were stratified by age and anatomic location of the lesions. Treatment response was coded as "complete," "partial," and "none." A total of 133 cases of EED with 381 lesions detailed in case reports and case series were included. Twenty-one cases were associated with HIV. Of 47 patients with reported paraproteinemias, IgA paraproteinemia was found in 57.45%, IgG paraproteinemia in 29.8%, IgM paraproteinemia in 10.6%, and IgD paraproteinemia in 2.1% of cases. Of 40 (30.1%) patients with reported comorbid autoimmune disease, rheumatoid arthritis was associated with 10 cases. Cancer was found to be associated with 9.77% of cases. Seventy-five patients were treated with dapsone, with 36 (48%) achieving complete treatment response, 24 (32%) achieving partial response, and seven (9.3%) achieving no response. Keeping the clinical associations of EED in mind, especially malignancy, is critical in management of the disease. More structured studies need to take place in order to fully define the mechanisms and strength of these associations.

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Section: Resultsmentioning

confidence: 99%

Erythema elevatum diutinum: a case report and review of literature

Doktor¹,

Hadi

Phelps

et al. 2018

Int J Dermatology

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“…4 Cases of EED associated with PUK are rare, with very few described in the literature. 1,5,6 Herein, we report on a case with biopsyproven EED associated with PUK, which, unlike previously reported cases, coexisted with RA and positive rheumatoid factor.…”

Section: Have Been Reportedmentioning

confidence: 75%

“…To our knowledge, three reports in the English literature have reported a total of five cases. 1,5,6 The clinical findings in these cases are summarized in Table 1. Takiwaki et al 1 suspect that the coexistence of EED and PUK is related to high titres of rheumatoid factor.…”

Section: Discussionmentioning

confidence: 99%

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A case of erythema elevatum diutinum associated with peripheral ulcerative keratitis

Jiao

Wang

2011

Aust J Dermatology

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“…55 Although EED occurs mainly in the age group 50-70 years, PUK associated with EED has been described in patients from 22 years to 81 years without a gender predisposition. 55,56,57,58,59 All patients respond to dapsone therapy. 55,56,57,58,59 Sweet syndrome is a neutrophilic dermatosis that is characterised by fever and sudden onset of painful erythematous nodules on the face, neck and extremities.…”

Section: Dermatosismentioning

confidence: 99%

Peripheral ulcerative keratitis: A review of aetiology and management

Hӧllhumer

2022

African Vision and Eye Health

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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.

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Erythema elevatum diutinum associated with peripheral ulcerative keratitis

Cited by 5 publications

References 5 publications

Erythema elevatum diutinum: a case report and review of literature

Erythema elevatum diutinum: a case report and review of literature

A case of erythema elevatum diutinum associated with peripheral ulcerative keratitis

Peripheral ulcerative keratitis: A review of aetiology and management

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