J Korean Ophthalmol Soc > Volume 55(6); 2014 > Article
Journal of the Korean Ophthalmological Society 2014;55(6):913-917.
DOI: https://doi.org/10.3341/jkos.2014.55.6.913    Published online June 15, 2014.
A Case of Peripheral Ulcerative Keratitis and Scleritis in a Patient with Pustular Psoriasis.
Tae Hee Lee, Yong Sok Ji, Seong Jin Kim, Kyung Chul Yoon
1Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea. kcyoon@jnu.ac.kr
2Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea.
농포건선 환자에서 발생한 주변부궤양각막염 및 공막염 1예
Department of Ophthalmology, Chonnam National University Medical School1, Gwangju, Korea
Department of Dermatology, Chonnam National University Medical School2, Gwangju, Korea
To report a case of peripheral ulcerative keratitis and scleritis in a patient with pustular psoriasis. CASE SUMMARY: A 62-year-old male presented with skin lesions on the hands and feet and pain in the right eye, which started a few days prior. Corrected visual acuity was 0.5 in the right eye and 0.7 in the left eye at initial visit. Corneal edema, erosion, ulcer and peripheral corneal infiltration of the right eye were observed. However, anterior chamber reaction was not observed. Histological analysis of hand skin lesions indicated pustular psoriasis. The patient was initially treated with topical antibiotics and a combined therapy of oral and topical steroids for ocular symptoms. As a result, the right eye showed slight improvement and the oral steroid was discontinued. One month after the initial visit, scleritis appeared on the left eye and topical and oral steroids were restarted for both eyes. Two months after the initial visit, ocular symptoms were improved significantly and corrected visual acuity was 1.0 in both eyes. The mild peripheral corneal opacity remained in the right eye, but the previous inflammations in both eyes were improved. CONCLUSIONS: As shown in this case, possibility of peripheral corneal infiltration, corneal ulcer and scleritis should be considered in patients with pustular psoriasis and topical and systemic steroids should be administered if accompanying ocular manifestations occur.
Key Words: Peripheral ulcerative keratitis;Pustular psoriasis;Scleritis

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