Moorfields Eye Hospital, London, United Kingdom.
Cornea. 2011 Aug;30(8):910-1. doi: 10.1097/ICO.0b013e3181f234bf.
To describe the history and clinical presentation of a case of primary epibulbar molluscum contagiosum in multiple myeloma, after penetrating keratoplasty.
A 70-year-old man, with previously diagnosed multiple myeloma and atopic dermatitis and keratoconjunctivitis, presented 6 months after right penetrating keratoplasty with white multilobular nodules of the right limbus. No skin lesions were evident. Evaluation consisted of slit-lamp examination, and an excisional biopsy of the involved conjunctival epithelium was carried out with local cryotherapy. Excised tissue was sent for histopathologic studies.
Slit-lamp examination revealed the presence of eight, 1-3 mm nodules of the perilimbal conjunctiva. In addition, there were opaque plaques at the level of the corneal epithelium. Mild perilesional conjunctival injection was evident, but there was no follicular conjunctival reaction. Histopathologic study of the lesions revealed eosinophilic intracytoplasmic inclusions (molluscum bodies) within the epithelial tissue.
There are no other reports of primary epibulbar molluscum, without previous cutaneous lesions, in immunocompromised patients without AIDS or after keratoplasty. This diagnosis should be included in the differential of focal thickening of the conjunctival epithelium, and potentially the corneal epithelium, in immunosuppressed patients.
描述一例多发性骨髓瘤患者在穿透性角膜移植术后发生原发性眼表传染性软疣的病史和临床表现。
一名 70 岁男性，患有多发性骨髓瘤、特应性皮炎和角膜结膜炎，在右眼穿透性角膜移植术后 6 个月，右眼角膜缘出现白色多叶状小结节。未发现皮肤损伤。评估包括裂隙灯检查，并对受累的结膜上皮进行局部冷冻切除术的切除活检。切除的组织被送去进行组织病理学研究。
裂隙灯检查显示，有 8 个 1-3 毫米大小的角膜缘周围小结节。此外，角膜上皮层有不透明斑块。周边结膜轻度充血，但无滤泡性结膜炎反应。病变组织的组织病理学研究显示上皮组织内存在嗜酸性细胞质内包涵体（软疣小体）。
在没有艾滋病或角膜移植术后的免疫功能低下患者中，没有其他关于无先前皮肤损伤的原发性眼表传染性软疣的报道。在免疫抑制患者中，对于结膜上皮和潜在的角膜上皮局灶性增厚，应将此诊断纳入鉴别诊断。
