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一名儿童因自行使用外用皮肤科皮质类固醇药物后发生角膜脓肿的病例。

A case of corneal abscess following self-medication with topical dermatologic corticosteroids in a child.

作者信息

Essaddouqui Esslimani Firdaouss, Khodriss Chaimae, Zefzoufi Soukaina, Kabbou Soukayna, El Bahloul Meriem

机构信息

Department of Ophthalmology, Faculty of Medicine and Pharmacy of Tangier, Abdelmak Essaadi University, Tangier, Morocco.

Department of Dermatology, Faculty of Medicine and Pharmacy of Tangier, Abdelmak Essaadi University, Tangier, Morocco.

出版信息

Oxf Med Case Reports. 2025 Jun 27;2025(6):omaf064. doi: 10.1093/omcr/omaf064. eCollection 2025 Jun.

Abstract

Topical dermatologic corticosteroids (TDC), while essential in treating skin conditions, can cause severe complications when misused, particularly in children. This case study reports a 7-year-old girl with a history of long-term self-medication with 0.05% betamethasone for dermatological lesions, resulting in iatrogenic Cushing's syndrome and a severe corneal abscess. The child presented with visual loss, corneal infiltrates, and hypopyon. Ocular and biochemical tests confirmed the diagnosis. The management included antifungal and antibacterial treatments, intrastromal voriconazole injection, and amniotic membrane grafting. TDC were gradually discontinued, and tacrolimus was used for skin symptoms. After 3 months, visual acuity improved to 3/10, with residual corneal opacity. This case emphasizes the dangers of prolonged TDC use without supervision and the need for early intervention in ocular complications.

摘要

外用皮质类固醇激素(TDC)虽然在治疗皮肤疾病方面至关重要,但滥用时会引发严重并发症,尤其是在儿童中。本病例报告了一名7岁女孩,她有长期自行使用0.05%倍他米松治疗皮肤病变的病史,导致医源性库欣综合征和严重角膜脓肿。患儿出现视力丧失、角膜浸润和前房积脓。眼科和生化检查确诊了病情。治疗措施包括抗真菌和抗菌治疗、基质内注射伏立康唑以及羊膜移植。逐渐停用TDC,并使用他克莫司治疗皮肤症状。3个月后,视力提高到3/10,角膜仍有残留混浊。该病例强调了在无监督情况下长期使用TDC的危险性以及对眼部并发症进行早期干预的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a3e/12202287/422bb798a1f4/omaf064f1.jpg

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