Bilateral Phlyctenular Keratoconjunctivitis in the Context of Hidradenitis Suppurativa: A Case Report and Literature Review.

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.

Bilateral neurosensory retinal detachment secondary to tadalafil treatment. / Desprendimiento neurosensorial retiniano bilateral secundario a tratamiento con tadalafilo.

A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal relationship has been confirmed, PDE5 inhibition at chorioretinal level produces vasodilatation, increased choroid hydrostatic pressure, and exudation into the subretinal space. In cases of NRD, a thorough assessment of the drug treatment history is crucial. Patients who use PDE5I drugs should be alerted to their potential ocular side effects.