Peripheral Ulcerative Keratitis with Pyoderma Gangrenosum

Imbernón-Moya, Adrián; Vargas-Laguna, Elena; Aguilar, A. Robledo; Gallego, Miguel A.; Vergara, Claudia Marsella Guzmán; Nistal, María Fernanda

doi:10.1155/2015/949840

Cited by 2 publications

(3 citation statements)

References 8 publications

(32 reference statements)

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“…Pyoderma gangrenosum is a neutrophilic dermatosis that is characterised by non-infective necrotic ulceration of the skin. 50,51 It is a rare condition with an annual incidence of 3-10 per million. 50 It is associated with a unilateral PUK that responds well to systemic CS and immunosuppression agents.…”

Section: Dermatosismentioning

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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Section: Dermatosismentioning

confidence: 99%

“…50 It is associated with a unilateral PUK that responds well to systemic CS and immunosuppression agents. 50,51,52,53,54 Erythema elevatum diutinum (EED) is a rare chronic dermatosis that is characterised by brown to purple plaques of the extensor surfaces of the skin. 55 Diagnosis is confirmed on skin biopsy.…”

Section: Dermatosismentioning

confidence: 99%

Peripheral ulcerative keratitis: A review of aetiology and management

Hӧllhumer

2022

African Vision and Eye Health

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“…PUK occurs in Behçet's disease during the exacerbation period with unilateral and sectoral involvement (6). PUK cases have also occasionally been reported in diseases such as pyoderma gangrenosum and autoimmune hepatitis (8,9).…”

Section: Introductionmentioning

confidence: 99%

Clinical findings, pathogenesis and treatment in non-infectious peripheral ulcerative keratitis

Açıkalın¹

2018

Beyoglu Eye J

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Peripheral ulcerative keratitis (PUK) is a group of diseases that manifest with ulceration and/or thinning in the peripheral cornea. Although this group of diseases can occur as a result of infection, most cases are of immunological origin and are associated with autoimmune diseases (AID). The most common form of AID associated with PUK is rheumatoid arthritis (RA). However, PUK may also be seen with other AIDs, such as systemic lupus erythematosus and Wegener's granulomatosis. There are immunological differences between the peripheral and central cornea that may explain the localization of PUK in the peripheral cornea. For example, the proximity to limbal blood vessels and conjunctival lymphatics is different. Both humoral and cellular immunity play a role in the development of PUK. Although the number of CD8+ T cells did not vary significantly in RA patients, the number of CD4+ T cells was significantly greater. As PUK is very serious, early diagnosis and treatment are very important. Local and systemic corticosteroids, immunosuppressants, biological agents, bandage contact lenses, tissue adhesives, and in some cases, surgical treatment can be applied. Adjacent conjunctival excision, patch lamellar grafts, and keratoplasty are options in surgical treatment. It is very important not to forget the possibility of disease progression despite surgery, and the treatment of underlying disease is crucial. Keratoplasty in PUK cases may not be successful as a result of several factors, such as dry eye and the underlying immunological disease..

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Peripheral Ulcerative Keratitis with Pyoderma Gangrenosum

Cited by 2 publications

References 8 publications

Peripheral ulcerative keratitis: A review of aetiology and management

Peripheral ulcerative keratitis: A review of aetiology and management

Clinical findings, pathogenesis and treatment in non-infectious peripheral ulcerative keratitis

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