Leucocytoclastic Vasculitis Presenting as Bilateral Ulcerative Keratitis: A Case Report

Introduction: Small artery disease caused by neutrophils and immune-mediated is known as leucocytoclastic vasculitis (LCV). Clinically, it manifests as palpable, asymptomatic purpuric papules on the limbs. Ocular manifestation is rare. Here, we describe a case of peripheral ulcerative keratitis (PUK...

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Main Authors: Hui Feng, Shang Li, Ying Jie
Format: Article
Language:English
Published: SAGE Publishing 2023-10-01
Series:Clinical Medicine Insights: Case Reports
Online Access:https://doi.org/10.1177/11795476231204358
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author Hui Feng
Shang Li
Ying Jie
author_facet Hui Feng
Shang Li
Ying Jie
author_sort Hui Feng
collection DOAJ
description Introduction: Small artery disease caused by neutrophils and immune-mediated is known as leucocytoclastic vasculitis (LCV). Clinically, it manifests as palpable, asymptomatic purpuric papules on the limbs. Ocular manifestation is rare. Here, we describe a case of peripheral ulcerative keratitis (PUK) associated with LCV. Case presentation: A 59-year-old man was referred to the hospital with blurred vision due to corneal perforation in his left eye. He complained of itchy nodules on his hands and lower legs for 15 years and the skin biopsy of the back of his hand revealed LCV 6 years ago, which suggested erythema elevatum diutinum. The patient was under treatment with anti-inflammatory and immunosuppressive drugs and physical features of LCV seen in him included erythema on his hands and legs. After receiving conjunctival flap covering surgery, the corneal perforation was resolved. Conjunctival flaps covered cornea that limited his vision to hand motion. Six months later, he was referred to our clinic again because of pain, redness, photophobia, and tearing in the right eye, presenting with PUK. Necrotic tissue was removed during surgery, which also included a conjunctival flap covering procedure. Following surgery, the symptoms were reduced, and the postoperative eye condition remained stable. Conclusion: To our knowledge, it is the first case of PUK secondary to LCV which was diagnosed 6 years ago. This case demonstrates that PUK associated with LCV can be successfully treated by surgical interventions.
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spelling doaj.art-100527acf8f44d3e8b0e7a0943215ecb2023-10-07T09:03:19ZengSAGE PublishingClinical Medicine Insights: Case Reports1179-54762023-10-011610.1177/11795476231204358Leucocytoclastic Vasculitis Presenting as Bilateral Ulcerative Keratitis: A Case ReportHui FengShang LiYing JieIntroduction: Small artery disease caused by neutrophils and immune-mediated is known as leucocytoclastic vasculitis (LCV). Clinically, it manifests as palpable, asymptomatic purpuric papules on the limbs. Ocular manifestation is rare. Here, we describe a case of peripheral ulcerative keratitis (PUK) associated with LCV. Case presentation: A 59-year-old man was referred to the hospital with blurred vision due to corneal perforation in his left eye. He complained of itchy nodules on his hands and lower legs for 15 years and the skin biopsy of the back of his hand revealed LCV 6 years ago, which suggested erythema elevatum diutinum. The patient was under treatment with anti-inflammatory and immunosuppressive drugs and physical features of LCV seen in him included erythema on his hands and legs. After receiving conjunctival flap covering surgery, the corneal perforation was resolved. Conjunctival flaps covered cornea that limited his vision to hand motion. Six months later, he was referred to our clinic again because of pain, redness, photophobia, and tearing in the right eye, presenting with PUK. Necrotic tissue was removed during surgery, which also included a conjunctival flap covering procedure. Following surgery, the symptoms were reduced, and the postoperative eye condition remained stable. Conclusion: To our knowledge, it is the first case of PUK secondary to LCV which was diagnosed 6 years ago. This case demonstrates that PUK associated with LCV can be successfully treated by surgical interventions.https://doi.org/10.1177/11795476231204358
spellingShingle Hui Feng
Shang Li
Ying Jie
Leucocytoclastic Vasculitis Presenting as Bilateral Ulcerative Keratitis: A Case Report
Clinical Medicine Insights: Case Reports
title Leucocytoclastic Vasculitis Presenting as Bilateral Ulcerative Keratitis: A Case Report
title_full Leucocytoclastic Vasculitis Presenting as Bilateral Ulcerative Keratitis: A Case Report
title_fullStr Leucocytoclastic Vasculitis Presenting as Bilateral Ulcerative Keratitis: A Case Report
title_full_unstemmed Leucocytoclastic Vasculitis Presenting as Bilateral Ulcerative Keratitis: A Case Report
title_short Leucocytoclastic Vasculitis Presenting as Bilateral Ulcerative Keratitis: A Case Report
title_sort leucocytoclastic vasculitis presenting as bilateral ulcerative keratitis a case report
url https://doi.org/10.1177/11795476231204358
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AT shangli leucocytoclasticvasculitispresentingasbilateralulcerativekeratitisacasereport
AT yingjie leucocytoclasticvasculitispresentingasbilateralulcerativekeratitisacasereport