Bilateral corneal involvement in epidermolysis bullosa acquisita.

PURPOSE: To report clinical and laboratory findings of bilateral corneal involvement in a patient with epidermolysis bullosa acquisita. METHODS: A 25-year-old man with a history of progressive and painless loss of vision in both eyes presented to our service with bilateral corneal involvement: peripheral corneal perforation in one eye and advanced corneal thinning in the other eye. There was concomitant dermatologic bullous disease. Clinical and laboratory exams were analyzed. RESULTS: The patient was diagnosed as having epidermolysis bullosa acquisita. Therapeutic corneal patch graft and conjunctival resection with cryotherapy were done, with satisfactory results. CONCLUSION: Bilateral corneal involvement in epidermolysis bullosa acquisita is described. To the best of our knowledge, this is the first description of such a case. Surgical management of the ocular findings associated with systemic therapy with colchicine seems to be a good therapeutic option in the management of this defying disease.

A histologic study of calcific and noncalcific band keratopathies.

One hundred five cases previously diagnosed as band keratopathy were reexamined. We found that band keratopathy was calcific noncalcific, or mixture of both. The noncalcific band was identified as elastotic degeneration of collagen, known clinically by various alternate terms. Cases of so-called reduplication of Bowman's membrane were reexamined, and many demonstrated production of a thick basement membrane of the corneal epithelium, with or without massive calcification. Identification of calcific-band keratopathy was made by transmission electron microscopy even when the tissue had been previously decalcified.