Perforation in interstitial keratitis associated with hidradenitis suppurativa: medical and surgical management.

Abstract

We present a case of bilateral interstitial keratitis leading to perforation in a woman with hidradenitis suppurativa (HS). A woman in her mid-20s with a history of HS and Grave's disease was referred to the corneal service with loss of vision and pain in both eyes since childhood. She was found to have circumferential thinning and steepening affecting her peripheral cornea bilaterally. Corrected distance visual acuity with spectacles was in the right eye 6/7.5, and in the left 6/30, with local thinnest area of 209 and 217 µm in the right and left eyes, respectively. She experienced recurring episodes of redness and irritation, and perforation occurred. The corneal perforation was managed with cyanoacrylate glueing, followed by a local conjunctival flap. Systemic immunosuppression with mycophenolate mofetil and adalimumab was commenced, with improvement after 18 months of treatment. Dermatologists and ophthalmologists should be aware of this association given its potential severity.

• Authors: Clare Quigley, Triona Butler, Conor Murphy, William Power
• Journal: BMJ case reports (BMJ Case Rep) Vol. 16 Issue 1 (Jan 27 2023) ISSN: 1757-790X [Electronic] England
• PMID: 36707098 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Adalimumab

Topics

• Female
• Humans
• Child
• Hidradenitis Suppurativa (complications)
• Keratitis (complications, surgery)
• Cornea (surgery)
• Corneal Perforation (etiology, therapy)
• Adalimumab