Rathinam S R, Namperumalsamy P, Nozik R A, Cunningham E T
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, India.
Ophthalmology. 1999 Mar;106(3):635-8. doi: 10.1016/S0161-6420(99)90129-X.
To describe three patients who developed Vogt-Koyanagi-Harada syndrome (VKH) after cutaneous injury.
Retrospective case series.
Three patients seen in the uveitis clinic at Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, India, participated.
The history, evaluation, and management of the three patients were summarized.
Three patients developed VKH syndrome shortly after cutaneous injury. In each case, the affected area of skin became vitiliginous on healing and simultaneous with the onset of ocular symptoms. One patient developed additional ectopic areas of vitiligo. All three patients developed chronic, bilateral, diffuse uveitis, one associated with an exudative retinal detachment and two with Dalen-Fuchs-like nodules. Well-recognized complications of VKH syndrome that occurred in the authors' patients included geographic atrophy of the retinal pigment epithelium (3 of 3), cataract (3 of 3), and glaucoma (1 of 3). Ocular inflammation was well controlled in each patient with local or systemic corticosteroids or both. In one patient, the area of vitiligo showed increased pigmentation in response to systemic corticosteroid treatment.
Vogt-Koyanagi-Harada syndrome may follow cutaneous injury, supporting the notion that this disorder may result from systemic sensitization to shared melanocytic antigens.
描述3例皮肤损伤后发生Vogt-小柳-原田综合征（VKH）的患者。
回顾性病例系列研究。
印度马杜赖阿拉文德眼科医院和眼科研究生学院葡萄膜炎门诊的3例患者参与研究。
总结3例患者的病史、评估及治疗情况。
3例患者在皮肤损伤后不久发生VKH综合征。每例患者愈合后的皮肤损伤部位均出现白癜风，且与眼部症状发作同时出现。1例患者出现额外的白癜风异位区域。所有3例患者均发生慢性双侧弥漫性葡萄膜炎，1例伴有渗出性视网膜脱离，2例伴有类多纳-富克斯（Dalen-Fuchs）结节。作者的患者中发生的VKH综合征公认并发症包括视网膜色素上皮地图样萎缩（3/3）、白内障（3/3）和青光眼（1/3）。每位患者的眼部炎症均通过局部或全身使用糖皮质激素或两者联合使用得到良好控制。1例患者的白癜风区域在接受全身糖皮质激素治疗后色素沉着增加。
Vogt-小柳-原田综合征可能继发于皮肤损伤，支持该疾病可能由对共同黑素细胞抗原的全身致敏引起这一观点。
