Sclerokeratitis and facial skin lesions: a case report of pyoderma gangrenosum and its response to dapsone therapy.

PURPOSE: This documents the evaluation and management of a patient with an unusual destructive external ocular disorder in the context of progressively disfiguring dermatitis.

METHODS

Observational case report including ophthalmologic examination with conjunctival and corneal scraping, radiologic studies of the sinuses and chest, skin, conjunctival, and scleral biopsies, and serologic studies.

RESULTS

Biopsies, cultures, and serologic testing led to the conclusion that the patient had pyoderma gangrenosum. Therapy with dapsone resulted in preservation of vision and resolution of the oculocutaneous inflammation.

CONCLUSIONS

Pyoderma gangrenosum is a rare autoimmune disorder that can affect the eye. Biopsy of affected tissue is the key to diagnosis. Immunomodulating therapy can be a useful adjunct to the traditional steroid therapy.