ABSTRACT
PURPOSE: To report a case of severe bilateral phlyctenular keratoconjunctivitis (PKC) associated to hidradenitis suppurativa (HS). CASE REPORT: A 26-year-old male with reactivation of HS in the last few months presented with concurrent pain and vision loss secondary to bilateral PKC resistant to topical treatment. There were no other infectious or autoimmune disorders. Systemic immunosuppression was needed, with simultaneous improvement of the ophthalmological and dermatological findings. CONCLUSIONS: Different inflammatory eye diseases have been reported in the context of HS. Acute inflammation in HS reactivation would trigger an autoimmune response, acting as a common causal mechanism in this association. We have reported a new case of inflammatory eye disease - HS in the form of PKC, not previously described in the literature, and consistent with immune dysregulation where the systemic Staphylococcus aureus burden due to HS may act as an additional causal factor.
Subject(s)
Autoimmune Diseases , Hidradenitis Suppurativa , Keratitis , Keratoconjunctivitis , Administration, Topical , Adult , Autoimmune Diseases/complications , Hidradenitis Suppurativa/complications , Hidradenitis Suppurativa/diagnosis , Hidradenitis Suppurativa/drug therapy , Humans , Keratitis/complications , Keratoconjunctivitis/diagnosis , Keratoconjunctivitis/drug therapy , Keratoconjunctivitis/etiology , MaleABSTRACT
BACKGROUND: Dermatofibrosarcoma protuberans is a rare malignant tumor with a high rate of recurrence after surgery. Moh's micrographic surgery allows examination of all surgical margins to ensure complete removal. OBJECTIVE: To evaluate the use of Moh's micrographic surgery using paraffin-embedded sections for the treatment of dermatofibrosarcoma protuberans. METHODS: We performed a retrospective analysis of 33 patients with dermatofibrosarcoma protuberans treated in our department with paraffin-embedded micrographic surgery between January 2002 and June 2015. Our cases included patients with primary untreated disease and also those with persistent disease previously treated surgically elsewhere, with histologically positive margins. RESULTS: Tumors were most commonly located on the trunk. After the first stage of micrographic surgery, including an initial lateral margin, 20 (60.6%) tumors were completely excised, 11 (33.3%) tumors required two stages and one tumor each (3.0%) required 4 and 6 stages respectively. Patients were monitored for recurrence for a mean duration of 6.5 years. There was no recurrence in any of our 33 patients. CONCLUSIONS: Our results indicate that Moh's micrographic surgery with paraffin-embedded sections may be the method of choice to treat dermatofibrosarcoma protuberans with a low recurrence rate, while preserving surrounding normal healthy tissue.
