Bilateral peripheral ulcerative keratitis in a patient with known Sézary syndrome

Abstract

Purpose: To report a case of bilateral peripheral ulcerative keratitis (PUK) in a patient with underlying Sézary syndrome.

Observations: A 58-year-old male presented with bilateral corneal ulceration with stromal thinning and was diagnosed with PUK. He was actively being treated for Sézary syndrome, a cutaneous T-cell lymphoma. He had no lagophthalmos or other adnexal abnormalities that would lead to ocular surface breakdown. A systemic autoimmune and infectious workup for PUK was unremarkable. His keratitis resolved after treatment with oral prednisone.

Conclusions and importance: We describe a previously undocumented association of PUK with Sézary syndrome in a patient without adnexal disease.

Keywords: Mycosis fungoides; Peripheral ulcerative keratitis; Sézary syndrome.

Fig. 1

External slit lamp photographs at 2 weeks after initial presentation. 1A.) Inferior paracentral stromal thinning with resolved epithelial defect OD. 1B.) Focal severe inferonasal stromal thinning OS.

Fig. 2

External slit lamp photographs at 3 months after initial presentation. 2A.) Stable inferior paracentral stromal thinning OD. 2B.) Stable focal severe inferonasal stromal thinning with fluorescein pooling and adjacent superficial neovascularization OS.