Kmera-Muszyńska Maria, Tesla Piotr, Okruszko Anna
Z Samodzielnego Publicznego Klinicznego Szpitala Okulistycznego w Warszawie.
Klin Oczna. 2009;111(4-6):128-30.
Pyoderma gangrenosum (PG) is a rare skin disease caused by immune dysfunction. The systemic diseases are often associated. The aim of the study was to report necrotic scleritis which developed after scleral buckling procedure in the case of the 64 years old patient suffered from primary retinal detachment and idiopathic PG. The retinal reattachment was achieved. The conjunctival wound dehiscence, necrotising scleritis and marginal keratitis as a manifestation of the patergic reaction were diagnosed. The treatment with corticosteroids locally (Dexamethason) and systematically (Prednison and Sulfasalazine), was administrated. The improvement and stabilisation of the local condition of ocular surface were observed. After reduction of systemic drugs, the exacerbation of local inflammation and vitritis was observed. The prolonged therapy was necessary. The risk of wound healing disturbances of an ocular surface with aggravated necrotic reaction must be expected after ocular surgery of the patient with PG. The adequate immunosupressive prolonged treatment with proper collaboration with the dermatologist is necessary.
坏疽性脓皮病（PG）是一种由免疫功能障碍引起的罕见皮肤病。常与全身性疾病相关。本研究旨在报告一名64岁患有原发性视网膜脱离和特发性PG的患者在巩膜扣带术后发生的坏死性巩膜炎。视网膜实现了复位。诊断出结膜伤口裂开、坏死性巩膜炎和边缘性角膜炎为超敏反应的表现。局部（地塞米松）和全身（泼尼松和柳氮磺胺吡啶）给予皮质类固醇治疗。观察到眼表局部状况有所改善并稳定。在全身药物减量后，观察到局部炎症和葡萄膜炎加重。需要延长治疗。PG患者眼部手术后，必须预计眼表伤口愈合障碍以及坏死反应加重的风险。进行充分的免疫抑制延长治疗并与皮肤科医生妥善协作是必要的。
