Posters

Cicatricial Ectropion in erythrodermic psoriasis: a case report

Poster Details

First Author: Z.Cheikh MOROCCO

Co Author(s): S. Homaide   M. Hammouche   S. Boussetta   A. Mchachi   L. Benhmidoune   M. Elbelhadji     

Abstract Details

Purpose:

we report the presenting ocular signs, symptoms, and complications of erythrodermic psoriasis in a case from Morocco

Setting:

Psoriasis is a common, chronic, inflammatory, systemic disease with major manifestations in the skin,with clearly defined erythematous and squamous plaques, other sites can also be affected,ocular involvement is particularly common, and the eyelids can be affected with blepharitis,chronic irritation, cicatricial ectropion, or other less commonmanifestations.

Methods:

A 9 year old female child was complaining of  ocular irritation with redness,in both eyes.She had been diagnosed with psoriatic arthritis 3 years ago. In her ocular examination, the visual acuity was 4/10 in the right eye and 6/10 in the left eye.The external examination revealed diffuse dry skin and cicatricial ectropion in both eyes. It was characterized by lower eyelid eversion and lacrimal punctum eversion.she had a decreased BUT(4 seconds).Fundoscopy was normal.We proposed a Surgical correction of the ectropion, but the parents refused, so she was treated with steroid ointments, and methylcellulose eye drops, with relief of ocular symptoms.

Results:

The incidence of ocular psoriasis is usually reported to be about 10% in all psoriasis patients. Psoriatic skin lesions, frequently develop on the eyebrow and hairline, but may also involve the eyelid, eyelid margin and periorbital area.These eyelid alterations can lead to cicatricial ectropion, wich is characterized by the eversion of the eyelid margin and the consequent exposure of the conjunctiva and cornea, leading to chronic conjunctivitis, keratitis,corneal ulceration, and lagophthalmos. The mechanisms of such ocular manifestations include the direct involvement of psoriatic plaques or a psoriasis associated autoimmune process.Surgical correction of the ectropion is usually required forsymptomatic relief.

Conclusions:

In summary, careful investigation should be performed in patients who have a skin disease that can lead to cicatricial ectropion. Because usually, only patients with advanced symptoms are referred for an ophthalmological evaluation. If the patient could be diagnosed earlier, ocular complications and the negative impact in the quality of life of these patients could be reduced.

Financial Disclosure:

None