M Showail, A E Rajab
Peripheral ulcerative keratitis (PUK) is an acute, destructive peripheral keratitis usually associated with an underlying systemic autoimmune disease. However, its association with hidradenitis suppurativa (HS) has been scarcely documented. We report a 35-year-old male with HS who presented with a 1-month history of a whitish spot in the left eye, associated with redness and pain. Visual acuity was 20/20 in the right eye and 20/30 in the left eye, with intraocular pressure of 14 mmHg and 13 mmHg, respectively. Slit-lamp examination revealed a crescent-shaped whitish peripheral corneal lesion at the 5 to 6 o'clock position near the limbus. Laboratory investigations were unremarkable except for elevated C-reactive protein, and the patient denied rheumatologic or autoimmune symptoms. He was treated with topical and systemic steroids, immunosuppressive therapy, biologic agents, and multiple conjunctival recession and resection procedures. PUK is a potentially serious but treatable condition; although the association with HS is rare, it should be considered in patients with HS presenting with ocular involvement.