BILATERAL PERIPHERAL ULCERATIVE KERATITIS ASSOCIATED WITH PYODERMA-GANGRENOSUM

Purpose. A 37-year-old Hispanic man with a history of chronic myelogen ous leukemia was first seen with fever and preseptal cellulitis of thi s right orbit after a tooth extraction. Methods, The patient subsequen tly developed bilateral, severe peripheral ulcerative keratitis. He wa s treated with systemic antibiotics for a presumed underlying infectio us cause. Several painful, necrotizing skin lesions developed over his face, trunk, and extremities. Results, Repeated skin biopsies of the necrotizing lesions were consistent with pyoderma gangrenosum. Both th e skin lesions and peripheral ulcerative keratitis responded dramatica lly to systemic prednisone. Conclusions. Pyoderma gangrenosum should b e included In the differential diagnosis of peripheral ulcerative kera titis.