Lazaar Hamza, Boutaj Taha, Sefrioui Meryem, ElMoubarik Najoua, Azarkan Boutayna, Benchekroun Saad, Amazouzi Abdellah, Boutimzine Noureddine, Cherkaoui Lalla Ouafa
Ophthalmology A, hôpital des Spécialités, Faculty of Medecine and Pharmacy of Rabat University Mohammed V, CHU Ibn Sina RABAY, Rabat, Morocco.
Ann Med Surg (Lond). 2024 May 17;86(8):4803-4806. doi: 10.1097/MS9.0000000000002179. eCollection 2024 Aug.
Ocular involvement in lichen planus is highly uncommon, primarily affecting the eyelids, conjunctiva, and less frequently, the cornea. Peripheral ulcerative keratitis (PUK), a rare subtype form of corneal lichen planus, has been reported only once in the literature.
The authors report details of a 34-year-old man with confirmed cutaneous lichen planus who developed severe PUK, a rare ocular manifestation of lichen planus. Despite initial worsening with corticosteroids, successful resolution of PUK was achieved with topical Cyclosporin and azathioprine over 2 months but with a final visual acuity limited to light perception.
To the best of our knowledge, very rare cases have been reported of the coexistence of severe PUK and lichen planus. Lichen planus should be considered in any case of PUKs associated with cutaneous-mucosal manifestations cyclosporin and azathioprine are crucial for effective management and favorable outcomes in such cases.
This case aims to show the importance of dermatological examination in the presence of any peripheral ulcerative keratitis. It also sheds light on the therapeutic difficulties and the prognosis of this rare form of ocular lichen planus.
扁平苔藓累及眼部极为罕见,主要影响眼睑、结膜,累及角膜的情况较少见。周边溃疡性角膜炎(PUK)是角膜扁平苔藓的一种罕见亚型,文献中仅报道过一例。
作者报告了一名34岁确诊为皮肤扁平苔藓的男性患者,其出现了严重的PUK,这是扁平苔藓一种罕见的眼部表现。尽管最初使用皮质类固醇后病情恶化,但在2个月内通过局部使用环孢素和硫唑嘌呤成功治愈了PUK,但最终视力仅保留光感。
据我们所知,严重PUK与扁平苔藓并存的病例报道极少。对于任何伴有皮肤黏膜表现的PUK病例,都应考虑扁平苔藓的可能,环孢素和硫唑嘌呤对于此类病例的有效管理和良好预后至关重要。
本病例旨在表明在任何周边溃疡性角膜炎病例中进行皮肤科检查的重要性。它还揭示了这种罕见的眼部扁平苔藓的治疗难点和预后情况。