金台診所醫學美容的部落格

Rare conjunctival inflammations you should remember

1-SLK (Superior limbic keratoconjunctivitis)
2-Ligneous conjunctivitis
3-Floppy eyelid
4-Parinaud's oculoglandular syndrome
5-Topical anesthetic abuse
6-Factitious conjunctivitis
7-Rosacea
8-Molluscum conjunctivitis



SLK (Superior limbic keratoconjunctivitis)
is a rare chronic inflammatory disease of the superior bulbar conjunctiva, limbus and upper cornea of unknown etiology. This disease has been associated with thyroid dysfunction, keratoconjunctivitis sicca and rheumatoid arthritis. Multiple treatment modalitites have been described but there is not a gold standard.

Ligneous conjunctivitis:
is a rare form of chronic, recurrent conjunctivitis characterized by wood-like, fibrinous pseudomembranes, which may be associated with systemic disease manifestations.

Floppy eyelid syndrome (FES):
characterized by chronic papillary conjunctivitis in upper palpebral conjunctiva that is poorly respondent to topical lubrication and steroids.

Parinaud's oculoglandular syndrome:
unilateral granulomatous conjunctivitis associated with preauricular and submandibular adenopathy. The adenopathy can be very marked . Cat-scratch disease is the most common cause of POS. Other causative organisms include Mycobacterium tuberculosis, Mycobacterium leprae, Francisella tularensis, Yersinia pseudotuberculosis, T pallidum, and C trachomatis.

Topical anesthetic abuse:
Ophthalmologists should be suspicious of topical anesthetic abuse keratopathy in young male manual laborers specialized in welding business and foundry work presenting with persistent epithelial defects, ring-shaped keratitis, and accompanying severe ocular pain.

Factitious (Self-inflicted) conjunctivitis:
Factitious disorder is a serious mental disorder in which someone deceives others by appearing sick, by purposely getting sick or by self-injury. Factitious disorder also can happen when family members or caregivers falsely present others, such as children, as being ill, injured or impaired.self-inflicted conjunctivitis can be reliably diagnosed by noting the characteristic clinical profile. Effective management includes addressing the underlying psychologic and social problems.

Rosacea:
is related to a common inflammatory condition affecting skin of the face and chest, as well as the eyes. While the exact cause of rosacea is unknown, the condition may be associated with inherited tendencies and environmental factors such as excessive sun exposure.

Rosacea occurs more frequently in women, but men are more likely to have severe forms of the disease. Eye involvement with rosacea is not unusual, although there is no definitive study indicating just how many people have eye or eyelid problems when they are diagnosed with the skin condition.

Molluscum conjunctivitis:
Molluscum lesions are waxy, elevated cutaneous nodules that frequently have an umbilicated center. They are caused by the molluscum contagiosum virus. In HIV-infected patients they can be numerous and diffuse. Molluscum lesions are often found on or near the eyelid margin. In those cases, a chronic follicular conjunctivitis is commonly seen, presumably related to the toxic effect of viral particles spilling onto the conjunctiva. Follicular conjunctivitis due to molluscum lesions does not respond to topical medications. Definitive treatment is removal of the offending lesion(s), either by excision or curettage.

By Dr.Kareem Bakr What is your recommendations for management of ligneous conjunctivitis, dear professor ??
By Dr.Gehad Elnahri There is new treatment; topical lys-plasminogen after excision