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PMID- 29668589
DCOM- 20180425
LR  - 20180502
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 16
DP  - 2018 Apr
TI  - Atopic keratoconjunctivitis: A diagnostic dilemma-a case report.
PG  - e0372
LID - 10.1097/MD.0000000000010372 [doi]
AB  - RATIONALE: Atopic keratoconjunctivitis (AKC) remains a difficult diagnosis
      despite advances in imaging technologies. This is a case study of the diagnostic 
      and treatment course for a patient with AKC. PATIENT CONCERNS: A 15-year-old male
      complained of progressively increasing pain, redness, watering and blurred vision
      in the right eye. The medical history showed that the patient suffered from
      itching on the hands, knees, neck and the eye skin one year before the onset of
      initial symptoms in the affected eye. DIAGNOSES: A final diagnosis of stage III
      AKC with atopic dermatitis (AD) was reached. INTERVENTIONS: The patient was used 
      0.1% tacrolimus eye drops and 0.3% gatifloxacin eye gel after antimicrobial
      susceptibility test was performed. In the presence of AD, 0.1% mometasone furoate
      cream and 0.03% tacrolimus ointment were applied twice daily. OUTCOMES: One month
      after starting treatment, the conjunctivitis and corneal ulcer rapidly improved
      along with reduced lid papillae. Macular grade corneal opacity was noticed with
      minimal thinning. The AD also rapidly improved. At the end of two months patient 
      was asymptomatic with a significant improvement in his quality of life. LESSONS: 
      Proper diagnosis of AKC especially when associated with dermatological signs
      along with management of AD in conjunction with dermatologist is necessary to
      prevent corneal involvement which can cause permanent visual disability is of
      utmost importance. We also noticed that topical tacrolimus is a good option for
      the treatment of severe AKC with AD along with systemic immunosupressants.
FAU - Li, Aipeng
AU  - Li A
AD  - Department of Ophthalmology, The First Hospital of Jilin University, Changchun.
FAU - Li, Shang
AU  - Li S
AD  - Department of Ophthalmology, Beijing You'an Hospital.
FAU - Ruan, Fang
AU  - Ruan F
AD  - Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University,
      Beijing Ophthalmology and Visual Science Key Lab, Beijing, R.P. China.
FAU - Jie, Ying
AU  - Jie Y
AD  - Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University,
      Beijing Ophthalmology and Visual Science Key Lab, Beijing, R.P. China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Allergic Agents)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Fluoroquinolones)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Ophthalmic Solutions)
RN  - 04201GDN4R (Mometasone Furoate)
RN  - L4618BD7KJ (gatifloxacin)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Administration, Topical
MH  - Adolescent
MH  - Anti-Allergic Agents/administration & dosage
MH  - Anti-Bacterial Agents/administration & dosage
MH  - *Conjunctivitis, Allergic/complications/diagnosis/drug therapy/physiopathology
MH  - Corneal Ulcer/diagnosis/drug therapy/etiology
MH  - *Dermatitis, Atopic/diagnosis/drug therapy/physiopathology
MH  - Fluoroquinolones/*administration & dosage
MH  - Humans
MH  - Immunosuppressive Agents/administration & dosage
MH  - Male
MH  - Mometasone Furoate/*administration & dosage
MH  - Ophthalmic Solutions/administration & dosage
MH  - Tacrolimus/*administration & dosage
MH  - Treatment Outcome
EDAT- 2018/04/19 06:00
MHDA- 2018/04/26 06:00
CRDT- 2018/04/19 06:00
PHST- 2018/04/19 06:00 [entrez]
PHST- 2018/04/19 06:00 [pubmed]
PHST- 2018/04/26 06:00 [medline]
AID - 10.1097/MD.0000000000010372 [doi]
AID - 00005792-201804200-00015 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(16):e0372. doi: 10.1097/MD.0000000000010372.