Perforating Peripheral Ulcerative Keratitis in Syphilis

Ploysangam, Pimpiroon; Mattern, Ruth

doi:10.1159/000501996

Cited by 7 publications

(7 citation statements)

References 9 publications

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“…Cat scratch disease 65 Herpes simplex 63,66,67,68 Lyme disease 69 Herpes zoster 63,70 Fungal Viral HIV 35,37,38,39,40,41,42…”

Section: Bacterial Bacterialmentioning

confidence: 99%

“…36 HIV has been described as a cause of PUK in several case reports. 35,37,38,39,40,41,42 This association has been made in newly diagnosed patients with no co-morbid conditions or in the presence of conditions associated with PUK. 38,39,42 These associated conditions were mostly infective in nature and included tuberculosis, herpes zoster ophthalmicus, RA, and syphilis.…”

Section: Human Immunodeficiency Virusmentioning

confidence: 99%

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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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“…Cat scratch disease 65 Herpes simplex 63,66,67,68 Lyme disease 69 Herpes zoster 63,70 Fungal Viral HIV 35,37,38,39,40,41,42…”

Section: Bacterial Bacterialmentioning

confidence: 99%

Section: Human Immunodeficiency Virusmentioning

confidence: 99%

Peripheral ulcerative keratitis: A review of aetiology and management

Hӧllhumer

2022

African Vision and Eye Health

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“…Die interstitielle Keratitis kann auch das initiale klinische Zeichen einer reaktivierenden Syphilis sein [26]. Gelegentlich nimmt die Keratitis auch einen ulzerativen Verlauf [27]. Die syphilitische Keratitis reagiert gut auf topische Kortikosteroide, nicht aber auf die Antibiotikatherapie.…”

Section: Syphilitische Läsionen Im Vorderen Augenabschnittunclassified

Augenbeteiligung bei venerischer Syphilis – Update

Rath

Scheel

Kriegel

et al. 2020

Klin Monbl Augenheilkd

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ZusammenfassungSyphilis ist eine bakterielle Infektionskrankheit, die durch die Spirochäte Treponema pallidum übertragen wird. Die Zahl von Neuerkrankungen ist in den letzten Jahren kontinuierlich gestiegen. Die Augenbeteiligung ist eine wohl unterschätzte Manifestation der Syphilis, die gehäuft bei HIV-positiven Patienten auftritt. Obschon praktisch jeder Teil der Augen im Rahmen einer Syphilis betroffen sein kann, tritt sie häufig mit einer posterioren oder Panuveitis auf. Eine besonders typische Verlaufsform ist die akute syphilitische plakoide Chorioretinitis, mit typischen Charakteristika in der multimodalen Bildgebung. Bei dem Verdacht auf eine Syphilis sind treponemenspezifische und nicht treponemenspezifische serologische diagnostische Tests angezeigt. Bei frühzeitigem Einsatz einer antibiotischen Therapie (primär mit Penicillin) werden oft gute Ergebnisse hinsichtlich Morphologie und Visus erzielt. Additive Kortikosteroide sollten verlaufsorientiert und erst nach dem Beginn der Antibiotikatherapie verwendet werden.

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“…It involves crescent-shaped corneal ulcers adjacent to the limbus. Epithelial defects may occur over areas of corneal stromal thinning, adjacent scleral and conjunctival involvement may occur [2]. It is thought to be the result of immune complex deposition in the limbus, resulting corneal inflammation.…”

Section: Introductionmentioning

confidence: 99%

A Case of Bilateral Peripheral Ulcerative Keratitis

Belghmaidi¹,

Zineb²,

Ibtissam³

et al. 2021

IJOVS

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Peripheral ulcerative keratitis (PUK) is an aggressive, potentially sight-threatening cause for peripheral corneal thinning. It may precede the diagnosis of the systemic condition and therefore these cases require urgent investigation. A 43year-old woman presented with bilateral tearing and ocular pain persisting for 7 months. Visual acuity was 6/6 in both eyes. On biomicroscopic examination, presence of crescent shaped corneal ulcer with perilesional haziness. A tear film study demonstrated decreased Schirmer test results (5mm in both eyes) and tear film break-up time (5 sec in both eyes). The interrogation and the patient revealed he had recurrent skin lesions in both legs with chronic itching, and recurrent oral and genital ulcers healing spontaneously. The diagnosis of Behcet disease was proposed. Pathergy test was negative, HLA B51 was positif. Systemic therapy was started with colchicine at a dose of 2mg/day. Eye drops and systemic prednisolone at 1mg/kg/day was continued with progressive decrease. The follow up at 3 months and 6 months showed no signs of recurrence of ulceration in both eyes. Corneal manifestation has rarely been reported in Behçet's disease. Combined intraocular anterior and posterior segment inflammation are most common features of ocular Behçet disease. Collaborative management of ophthalmic patients having systemic illness along with internists improves overall outcomes and prevents morbidity in such patients.

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Perforating Peripheral Ulcerative Keratitis in Syphilis

Cited by 7 publications

References 9 publications

Peripheral ulcerative keratitis: A review of aetiology and management

Peripheral ulcerative keratitis: A review of aetiology and management

Augenbeteiligung bei venerischer Syphilis – Update

A Case of Bilateral Peripheral Ulcerative Keratitis

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