Seitz B
Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg.
Klin Monbl Augenheilkd. 1994 Feb;204(2):142-3. doi: 10.1055/s-2008-1035511.
Over a period of one year a 33-year-old married housewife, mother of two healthy children, complained of an initially recurrent, in the last 6 months persisting conjunctivitis, upper and lower lid edema, dacryorrhea and photophobia concerning the left eye. Neither topical derivates of cromoglycin acid, antibiotics nor steroids brought relief. Half a year ago the patient had noticed a "little nodule" of the lateral upper eyelid without tendency to grow. The visual acuity was 0.8 due to a punctate superficial keratopathy. In addition a marked follicular conjunctivitis was present. Our examination revealed a little whitish-rosy tumor with elevated edges and a central crater at the lateral margin of the upper lid. The right eye was completely normal. The tumor was totally excised preserving the lid margin. Our histopathological diagnosis was "molluscum contagiosum". Four weeks after surgery the keratoconjunctivitis had subsided without further medication.
In persisting unilateral conjunctivitis without amelioration after any topical therapy the eyelids should be checked carefully for a tumor to be excised. In older patients a sebaceous gland carcinoma must be ruled out. Considering the patient's personal history a chlamydial infection should be kept in mind as a differential diagnosis.
在一年的时间里,一名33岁的已婚家庭主妇,育有两个健康孩子,主诉左眼最初反复出现、在过去6个月持续存在的结膜炎、上下眼睑水肿、溢泪和畏光。色甘酸的局部衍生物、抗生素和类固醇均未能缓解症状。半年前患者注意到上睑外侧有一个“小结节”,无生长趋势。由于点状浅层角膜病变,视力为0.8。此外,还存在明显的滤泡性结膜炎。我们的检查发现上睑外侧边缘有一个略呈白色玫瑰色的肿瘤,边缘隆起,中央有一个凹陷。右眼完全正常。肿瘤被完整切除,保留了睑缘。我们的组织病理学诊断为“传染性软疣”。手术后四周,角结膜炎未经进一步药物治疗即已消退。
对于任何局部治疗后仍持续存在且无改善的单侧结膜炎,应仔细检查眼睑是否有肿瘤需要切除。对于老年患者,必须排除皮脂腺癌。考虑到患者的个人病史,衣原体感染应作为鉴别诊断予以考虑。