Jifi-Bahlool H, Saadeh C, O'Connor J
Division of Rheumatology, Allergy, and Immunology, Texas Tech University Health Sciences Center (TTUHSC), Amarillo 79106, USA.
Semin Arthritis Rheum. 1995 Aug;25(1):67-73. doi: 10.1016/s0049-0172(95)80019-0.
Peripheral ulcerative keratitis (PUK) is a rare but serious inflammatory eye condition that can complicate rheumatoid arthritis. PUK can be a warning sign of impending vasculitis, and cytotoxic therapy may be necessary to induce remission. We have encountered three patients with PUK in the past year. Two patients had long-standing quiescent rheumatoid arthritis who developed photophobia. Diagnosis was made by slit lamp examination. Treatment with local cyclophosphamide and prednisone resulted in prompt remission of the ulcer within 8 weeks. Cytotoxic therapy was discontinued altogether within 6 months. The third patient was also treated successfully with oral steroids and azathioprine. In all patients, sicca was noted. None of them had any evidence of systemic vasculitis. PUK, when recognized early and treated aggressively, can result in remission of the ulcer and in the prevention of vasculitis. Keratoconjunctivitis sicca can accompany PUK independent of the activity of rheumatoid arthritis.
周边溃疡性角膜炎（PUK）是一种罕见但严重的眼部炎症性疾病，可并发类风湿关节炎。PUK可能是即将发生血管炎的警示信号，可能需要细胞毒性疗法来诱导病情缓解。在过去一年里，我们遇到了3例PUK患者。其中2例患有长期静止的类风湿关节炎，出现了畏光症状。通过裂隙灯检查做出诊断。局部使用环磷酰胺和泼尼松治疗，8周内溃疡迅速缓解。6个月内完全停用细胞毒性疗法。第3例患者口服类固醇和硫唑嘌呤治疗也取得成功。所有患者均有干眼症。他们均无任何系统性血管炎的证据。PUK若能早期识别并积极治疗，可使溃疡缓解并预防血管炎。干眼症可独立于类风湿关节炎的活动情况而伴随PUK出现。
