Ocular Involvement in Erythema Multiforme

Patz, Arnall

doi:10.1001/archopht.1950.00910010251007

Cited by 32 publications

(12 citation statements)

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confidence: 99%

“…Two-thirds of patients have a conjunctivitis of variable intensity as part of the syndrome (Patz 1950;534 Howard 1963;Yetiv et al 1980;Prendiville et al 1989). Its most severe form is a membranous, supposedly necrotizing conjunctivitis, frequently complicated by bacterial superinfection and followed by progressive subepithelial scarring during the convalescence period (Patz 1950;Howard 1963;Arstikaitis 1973;Magli et al 1981;Prendiville et al 1989). Indeed, cicatricial entropion, trichiasis, symblepharon, ankyloblepharon, lagophthalmos, keratinization of conjunctival epithelium and dry eye syndrome, leading to corneal neovascularization, opacities and perforation are the most important late effects of Stevens-Johnson syndrome (Patz 1950;Howard 1963;Arstikaitis 1973;Yetiv et al 1980;Wright 8c Collin 1983;Prendiville et al 1989).…”

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confidence: 99%

“…Its most severe form is a membranous, supposedly necrotizing conjunctivitis, frequently complicated by bacterial superinfection and followed by progressive subepithelial scarring during the convalescence period (Patz 1950;Howard 1963;Arstikaitis 1973;Magli et al 1981;Prendiville et al 1989). Indeed, cicatricial entropion, trichiasis, symblepharon, ankyloblepharon, lagophthalmos, keratinization of conjunctival epithelium and dry eye syndrome, leading to corneal neovascularization, opacities and perforation are the most important late effects of Stevens-Johnson syndrome (Patz 1950;Howard 1963;Arstikaitis 1973;Yetiv et al 1980;Wright 8c Collin 1983;Prendiville et al 1989). An identical pseudomembranous or membranous conjunctivitis may also accompany related hypersensitivity reactions, such as Lyell's syndrome (Mondino 1990;Prendiville et al 1989).…”

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confidence: 99%

“…Treatment of membranous conjunctivitis associated with immunologically mediated hypersensitivity reactions has changed little during the last thirty years (Patz 1950;Howard 1963Howard ,1990. In particular, debridement of the inflammatory membranes has seldom been commented on and remains controversial (Patz 1950;Howard 1963;Prendiville et al 1989).…”

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Pseudomembranous and membranous conjunctivitis Immunohistochemical Features

Kivelä

Tervo

Ravila³

et al. 1992

Acta Ophthalmologica

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A 63-year-old man, who had for one month been on sulfasalazine therapy, developed general malaise, high fever, severe stomatitis, and bilateral necrotizing pseudomembranous conjunctivitis with corneal erosion, identical to that seen in the Stevens-Johnson syndrome. Topical therapy with antibiotics and aprotinin rapidly healed the corneal surfaces, while densely adherent true membranes developed on the conjunctiva, and were removed surgically several times during the next week. After the acute stage, subtle subepithelial conjunctival scarring, superficial punctate keratitis, dry eye syndrome and fluctuating irregular corneal astigmatism became evident, but good visual acuity, lid function and ocular motility were retained. Histopathologic study of conjunctival membranes from two cases of membranous conjunctivitis revealed polymorphonuclear leukocytes within a matrix composed of fibrin, tenascin and fibronectin. In older membranes, histiocytes were additionally found. Surgical debridement of such membranes removes a substratum of inflammatory debris that is likely to promote secondary infection, fibrosis and symblepharon formation, and may decrease rather than increase subsequent scarring of the necrotized conjunctiva.

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Pseudomembranous and membranous conjunctivitis Immunohistochemical Features

Kivelä

Tervo

Ravila³

et al. 1992

Acta Ophthalmologica

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“…Duke-Elder considers the pseudomembranous form the most common one, Patr (19) the purulent. In mild cases the mucous membranes return to normal again, while in the more serious cases permanent scars persist, in some cases with symblepharon formation and keratoconjunctivitis sicca.…”

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confidence: 99%