与扁平苔藓相关的双侧角结膜炎。
Bilateral keratoconjunctivitis associated with lichen planus.
作者信息
Rhee Michelle K, Mootha V Vinod
机构信息
Eye and Ear Institute of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA.
出版信息
Cornea. 2004 Jan;23(1):100-5. doi: 10.1097/00003226-200401000-00019.
PURPOSE
To describe a case of bilateral keratoconjunctivitis in a patient with lichen planus.
METHODS
Case report and review of the English literature.
RESULTS
To our knowledge, this is the fourth reported case of keratoconjunctivitis associated with lichen planus. A 33-year-old Navajo man with lichen planus had recurrent and progressive keratoconjunctivitis that failed to improve on multiple topical medications. Tapered oral prednisone, 2% topical cyclosporin, and amniotic membrane transplantation pacified the acute exacerbation.
CONCLUSIONS
Our patient with lichen planus developed an ocular surface disease with cicatricial conjunctivitis, keratouveitis, keratoconjunctivitis sicca, punctate epithelial erosions, and persistent epithelial defects leading to noninfectious or infectious corneal ulceration. Amniotic membrane transplantation may play an adjunctive role in refractory cases of lichen planus-related keratoconjunctivitis. Topical cyclosporin may stabilize the ocular surface when combined with systemic immunosuppression in severe cases.
目的
描述1例扁平苔藓患者发生双侧角结膜炎的病例。
方法
病例报告及英文文献复习。
结果
据我们所知，这是第4例报道的与扁平苔藓相关的角结膜炎病例。1名33岁患扁平苔藓的纳瓦霍族男性发生复发性、进行性角结膜炎，多种局部用药均未能改善病情。逐渐减量的口服泼尼松、2%的局部用环孢素及羊膜移植使急性加重得到缓解。
结论
我们的扁平苔藓患者发生了一种眼表疾病，伴有瘢痕性结膜炎、角膜葡萄膜炎、干燥性角结膜炎、点状上皮糜烂及持续性上皮缺损，进而导致非感染性或感染性角膜溃疡。羊膜移植在扁平苔藓相关角结膜炎的难治性病例中可能起辅助作用。在严重病例中，局部用环孢素与全身免疫抑制联合应用时可稳定眼表。
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