1/4. Fascicular keratitis in children: can corneal phlycten be mobile?Phlyctenulosis is an uncommon condition that usually affects children's cornea or conjunctiva. Although its exact aetiology is unknown, it is thought to be a non-specific delayed hypersensitivity reaction to staphylococci or other bacterial, fungal or parasitic antigens. Herein a case of a 3.5-year-old boy with corneal phlyctenulosis is described in whom the phlycten appears to have has migrated from its origin at the limbus to the central cornea (fascicular keratitis) and become visually disabling. At his last follow up he was asymptomatic. Some stromal scarring of the right cornea remained and his visual acuity improved in both eyes following treatment.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/4. Phlyctenular keratoconjunctivitis.There is growing evidence that a variety of corneal disorders may be expressions of altered immune mechanisms. Phlyctenular keratoconjunctivitis is probably such a condition. Typically described as arising from hypersensitivity to tuberculin protein, other antigens clearly may participate, particularly staphylococcus products. When corneal involvement occurs, it need not be confined to the peripheral cornea. The symptoms of the process may be disproportionate to obvious findings and so exaggerated as to suggest a psychiatric disorder. Resultant visual deficits, if the disease is corneal, progressive, unrecognized, and untreated may be profound. Representative examples of this disease are cited. Immune mechanisms are reviewed. The importance of recognizing the characteristic sign and symptom complex is stressed. Appropriate diagnostic studies and treatment regimens are presented.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/4. lichen planus and Sjogren-type sicca syndrome in a patient with chronic hepatitis c.We report a 54-year-old Japanese male with lichen planus and Sjogren-type sicca syndrome, accompanied by the latent complication of chronic hepatitis c. The patient first showed erythematous and erosive lesions with white irregular striae in the buccal mucous membrane, and blepharitis and hyperemia of conjunctiva in his eyes. He later had two small erosions on the glans penis, and flat-topped violaceous papules on the dorsa manus and nape. A biopsy specimen of the lower lip lesion demonstrated a lichenoid tissue reaction at the basement membrane zone, and lymphocytic focal accumulations in the salivary glands. Immunohistochemical study of this specimen revealed CD45RO- (T) cells associated with the expression of hla-dr antigens predominantly in both the lichenoid tissue reaction and the lymphocytic sialadenitis. Objective keratoconjunctivitis sicca was confirmed by the Schirmer and Rose-Bengal tests. Anti-dna antibody was positive; however anti-SS-A, and anti-SS-B antibodies were negative. Increased levels of transaminase enzymes, TTT, ZTT, and IgG were observed in first laboratory examinations; thereafter, antihepatitis C virus (HCV) antibodies and HCV-rna were detected. The high serum amylase level, in which salivary amylase predominated, was normalized by etretinate therapy in parallel with the clinical improvement of the oral LP lesions. Our case is considered to support the hypothesis that an etiologic association may be present among lichen planus, sjogren's syndrome, and chronic hepatitis c.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/4. herpes simplex eye infections: clinical manifestations, pathogenesis and management.Herpes infection of the eye may be acquired as the patient's first exposure to the virus (primary infection) or as involvement of a new anatomical site (the eye) in a patient with previous HSV infection. In either case, patients with herpetic eye infection risk recurrent eye disease throughout their lives. The infective lesions of the corneal epithelium (dendritic and geographic ulcers) occasionally develop into noninfective indolent or trophic ulcers, particularly under the influence of cauterizing chemicals or corticosteroids. inflammation of the corneal stroma may accompany herpetic epithelial lesions or occur independently. Stromal keratitis probably represents the host's immune response to viral antigens filtering down from epithelial lesions or from viral replication in stromal cells. The clinical manifestations of ocular HSV infection are reviewed, pathogenesis and possible pathways of the infection are analyzed, and some practical guidelines for management and prevention are presented.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |