Vol 36 No 1 Case Report PDF

Peripheral ulcerative keratitis in Sweet syndrome

Denise Ramona Carbonell, MD, Maria Cecilia Gertrudis Agdeppa, MD, DPBO, Margarita Nahleen N. Mejia, MD

To present a case of peripheral ulcerative keratitis (PUK) in a patient with Sweet syndrome (acute febrile neutrophilic dermatosis) and discuss its etiopathogenesis, clinical presentation, course, and management.

This is a case report.

A 31-year-old male, diagnosed with Sweet syndrome, was referred for redness, photophobia, and severe, deep, boring pain in the right eye. Visual acuity was 20/20 bilaterally. Inferior sectoral conjunctival and scleral hyperemia were present in the right eye. Initial treatment included topical and oral nonsteroidal antiinflammatory drugs (NSAIDs), a topical immunosuppressive agent, and an antibiotic. One month after treatment, the pain decreased but patient developed peripheral corneal thinning that gradually spread circumferentially and centrally in the right eye. Vision decreased to 20/400. A similar inferior sectoral injection was noted in the left eye. Oral prednisone was started, followed by oral immunosuppressive agent. Resolution of the PUK was noted after 1 month of immunosuppressive treatment with improvement of the vision.

PUK is a potentially blinding disorder that can be seen in Sweet syndrome. With proper knowledge of the underlying disease, close monitoring and management, PUK can be treated and cured.

Keywords: Acute febrile neutrophilic dermatosis, Conjunctivitis, Ocular inflammation, Peripheral ulcerative keratitis, Sweet syndrome