Haridas Anjana S, Sullivan Timothy J
Oculoplastics, Lacrimal and Orbital Service, Dept of Ophthalmology, Royal Brisbane & Women's Hospital, Brisbane, Australia; Department of Surgery University of Queensland, Brisbane, Australia.
Ophthalmic Plast Reconstr Surg. 2016 Jan-Feb;32(1):e12-5. doi: 10.1097/IOP.0000000000000385.
Pityriasis rubra pilaris is an idiopathic, papulosquamous dermatological disease. It is clinically and histologically distinct from, but may resemble, psoriasis. Pityriasis rubra pilaris can be self-limiting but may also run a protracted, relapsing course. Medical treatment may involve topical emollients, systemic retinoids, methotrexate, and/or tumor necrosis factor antagonists. Ocular complications include cicatricial ectropion. The authors describe the surgical management of 3 patients with cicatricial ectropion secondary to pityriasis rubra pilaris. All patients had procedures involving skin grafts; 1 patient required multiple operations. The management principles are discussed, including the role and timing of surgery, within the context of emerging treatments for pityriasis rubra pilaris. Patients with pityriasis rubra pilaris and cicatricial ectropion should be closely managed by both ophthalmologist and dermatologist. The eyelid position may improve with conservative or surgical measures. If surgery is required, the limitations of skin grafting under these circumstances should be anticipated and patients counseled appropriately.
红皮病型毛发红糠疹是一种特发性丘疹鳞屑性皮肤病。它在临床和组织学上与银屑病不同，但可能相似。红皮病型毛发红糠疹可以是自限性的，但也可能病程迁延、反复发作。医学治疗可能包括外用润肤剂、系统性维甲酸、甲氨蝶呤和/或肿瘤坏死因子拮抗剂。眼部并发症包括瘢痕性睑外翻。作者描述了3例继发于红皮病型毛发红糠疹的瘢痕性睑外翻患者的手术治疗。所有患者均接受了涉及皮肤移植的手术；1例患者需要多次手术。在红皮病型毛发红糠疹新兴治疗方法的背景下，讨论了管理原则，包括手术的作用和时机。红皮病型毛发红糠疹和瘢痕性睑外翻患者应由眼科医生和皮肤科医生密切管理。眼睑位置可通过保守或手术措施改善。如果需要手术，应预料到在这些情况下皮肤移植的局限性，并对患者进行适当的咨询。
