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盘状红斑狼疮患者出现类似慢性睑缘炎的表现——病例系列

Chronic blepharitis like picture in patients with Discoid lupus erythematosis - Case series.

作者信息

Jisha K, Rajesh P S, Kurien George, Sathish Gargi, Vijayamma N

出版信息

Nepal J Ophthalmol. 2017 Jul;9(18):175-179. doi: 10.3126/nepjoph.v9i2.19264.

Abstract

BACKGROUND

Blepharitis is a very common condition encountered in ophthalmology outpatient care department. Dermatological diseases like seborrheic keratopathy and rosacea have been frequently discussed as being associated with blepharitis. However Discoid lupus erythematosis [DLE], an autoimmune condition has only rarely been reported to involve the eyelids mimicking blepharitis. DLE affecting the eyelids can produce significant morbidity with lid deformities, trichiasis and symblepharon if left untreated.

OBJECTIVE

To report three consecutive cases of DLE with eyelid lesions mimicking blepharitis. They presented to the department of ophthalmology at our institute from April 2014 to March 2016. The first case presented with involvement of lower eyelid in one eye. She was having multiple skin lesions which on biopsy confirmed the diagnosis of DLE. The second case was a diagnosed case of DLE who received treatment 4 years back and came with relapse of the disease affecting the eyelid. The third case was a recently biopsy confirmed case of DLE with multiple skin lesions along with bilateral eyelid involvement. Two of them had madarosis and one case had destruction of the outer lid margin at presentation. All three cases responded well to treatment with Hydrxychloroquin.

CONCLUSION

The discoid lesions of DLE affecting the eyelids can mimic the appearance of chronic blepharitis. Ophthalmologists should be aware that DLE is a possibility while dealing with an atypical case of chronic blepharitis. Early diagnosis and treatment can prevent deformities of eyelid.

摘要

背景

睑缘炎是眼科门诊常见的病症。脂溢性角化病和酒渣鼻等皮肤病常被讨论与睑缘炎有关。然而,盘状红斑狼疮(DLE)这种自身免疫性疾病仅有极少报道累及眼睑,表现类似睑缘炎。如果不治疗,累及眼睑的DLE可导致严重的并发症,如眼睑畸形、倒睫和睑球粘连。

目的

报告3例连续的表现类似睑缘炎的眼睑病变的DLE病例。这些病例于2014年4月至2016年3月就诊于我院眼科。第一例为单眼下睑受累。她有多处皮肤病变,活检确诊为DLE。第二例是4年前确诊的DLE病例,此次因疾病复发累及眼睑前来就诊。第三例是最近经活检确诊的DLE病例,有多处皮肤病变且双侧眼睑受累。其中2例有睫毛脱落,1例就诊时外睑缘破坏。所有3例对羟氯喹治疗反应良好。

结论

累及眼睑的DLE盘状病变可类似慢性睑缘炎的表现。眼科医生在处理非典型慢性睑缘炎病例时应意识到存在DLE的可能性。早期诊断和治疗可预防眼睑畸形。

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