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Bilateral peripheral ulcerative keratitis associated with pyoderma gangrenosum
C S Bouchard1, M A Meyer, J F McDonnell
1Department of Ophthalmology, Loyola University Medical Center, Chicago, Illinois 60153, USA.
Purpose:
A 37-year-old Hispanic man with a history of chronic myelogenous leukemia was first seen with fever and preseptal cellulitis of this right orbit after a tooth extraction.
Methods:
The patient subsequently developed bilateral, severe peripheral ulcerative keratitis. He was treated with systemic antibiotics for a presumed underlying infectious cause. Several painful, necrotizing skin lesions developed over his face, trunk, and extremities.
Results:
Repeated skin biopsies of the necrotizing lesions were consistent with pyoderma gangrenosum. Both the skin lesions and peripheral ulcerative keratitis responded dramatically to systemic prednisone.
Conclusions:
Pyoderma gangrenosum should be included in the differential diagnosis of peripheral ulcerative keratitis.