Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0851184 (thinning)
 11,252 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Peripheral ulcerative keratitis (PUK) is a sight-threatening condition characterized by an epithelial defect, crescent-shaped stromal inflammation, and progressive stromal thinning. Peripheral ulcerative keratitis as a purely inflammatory entity is most commonly associated with collagen vascular diseases, including rheumatoid arthritis, polyarteritis nodosa, Wegener granulomatosis, systemic lupus erythematosus, and relapsing polychondritis. PUK can also be associated with infectious and inflammatory conditions such as hepatitis, syphilis, herpes simplex keratitis, fungal keratitis, Mooren ulcer, and marginal keratitis. We describe a case report of PUK associated with the inflammatory condition of sarcoidosis.
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PMID:Peripheral ulcerative keratitis in association with sarcoidosis. 2399 5

Ocular syphilis has varied manifestations in the eye. Peripheral ulcerative keratitis (PUK) is a crescent-shaped ulcer involving the peripheral cornea and associated with thinning. PUK is caused by both autoimmune and infectious diseases, such as rheumatoid arthritis, tuberculosis, and herpes. Here, we report a rare case of bilateral PUK caused by syphilis. A 55-year-old man presented with recurrent pain and redness in both eyes for 2 months. The cornea of both eyes had bilateral peripheral crescent-shaped ulcers suggestive of PUK. The patient was started on topical steroids elsewhere, but the lesion was not showing any signs of healing. A series of investigations were performed, with positive venereal disease research laboratory and fluorescent treponemal antibody absorption tests. The patient was then started on systemic penicillin, as well as topical steroids. The response to the treatment was good and the ulcer began to heal. PUK as the presenting feature of acquired syphilis is a rare scenario. Such infective causes should be managed with systemic antimicrobials for optimal outcomes.
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PMID:Ocular syphilis masquerading as bilateral peripheral ulcerative keratitis. 2901 44

Peripheral ulcerative keratitis (PUK) is an aggressive, potentially sight-threatening cause for peripheral corneal thinning. It is thought to be the result of immune complex deposition at the limbus, resulting in corneal inflammation and stromal melt. We present a case of a 43-year-old female patient of African origin, presenting with PUK and associated corneal perforation as the primary presentation of HIV infection. An urgent tectonic deep anterior lamellar keratoplasty was performed under general anaesthesia with excellent outcome. The patient was referred to the sexual health clinic and anti-retroviral treatment was initiated. This case is to the best of our knowledge the first report from the UK of PUK with corneal perforation as the primary presentation of HIV infection. As highlighted in this report, infection with HIV may initially be silent; therefore, it is vital to consider HIV infection when dealing with PUK of unknown aetiology.
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PMID:Peripheral ulcerative keratitis with corneal melt as the primary presentation in a case of human immunodeficiency virus. 3079 72

Peripheral ulcerative keratitis (PUK) is a group of corneal disorders that cause peripheral corneal thinning, threatening globe integrity in advance stages. It is usually associated with systemic autoimmune diseases and management is based on local and systemic approaches. We present the case of a 47-year-old man with a previous history of bacterial keratitis in his left eye presenting with 1 month of bilateral ocular pain and redness. At examination, diffuse bilateral globe inflammation with paracentral corneal thinning in his left eye was observed. He was diagnosed with bilateral scleritis and PUK in his left eye. Workup for associated systemic autoimmune disease yielded negative results. The patient was started on pulses of intravenous methylprednisolone followed by oral prednisone failing to achieve sufficient control of the inflammatory syndrome. Subsequently, periodic intravenous cyclophosphamide was administered with a favorable response. A multilayer amniotic membrane graft was applied, but there was rapid melting with reabsorption of the tissue, resulting in extreme corneal thinning at the inferior paracentral cornea. A decentered 8.5-mm superficial anterior lamellar keratoplasty (SALK) was then performed obtaining the donor graft with a femtosecond laser but performing manual trepanation in the recipient. At 12 months, visual and biomicroscopic measures do not show deterioration and inflammation remains under control with oral azathioprine as maintenance regime. The management of PUK includes both systemic immunosuppression and tectonic procedures to preserve the globe integrity. Diverse surgical techniques have been attempted, but no definitive guidelines are available. Decentered large SALK is a simple technique that can yield acceptable visual results.
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PMID:Peripheral Ulcerative Keratitis in a Patient with Bilateral Scleritis: Medical and Surgical Management. 3317 97