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  In this article
   Abstract
   Introduction
   Case Report
   Discussion
   References

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CASE REPORT
Year : 2000  |  Volume : 66  |  Issue : 5  |  Page : 257-258

Non-arthropathic psoriasis associated with uveitis




Correspondence Address:
Pramod Kumar


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Source of Support: None, Conflict of Interest: None


PMID: 20877095

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  Abstract 

A patient with non-arthropathic psoriasis and associated uveitis is reported.


Keywords: Uveitis, Non-arthropathic psoriasis, Psoriasis


How to cite this article:
Kumar P, Sharma P K, Gautam R K, Kar H K. Non-arthropathic psoriasis associated with uveitis. Indian J Dermatol Venereol Leprol 2000;66:257-8

How to cite this URL:
Kumar P, Sharma P K, Gautam R K, Kar H K. Non-arthropathic psoriasis associated with uveitis. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2020 Jun 4];66:257-8. Available from: http://www.ijdvl.com/text.asp?2000/66/5/257/4940



  Introduction Top


The ocular lesions in psoriasis have been noted in the form of blepharitis, conjunctivitis, keratitis, xerosis, symblepharon, trichiasis, episcleritis and keratoconjunctivitis sicca. [1],[2] Chronic uveitis has also been reported in patients with arthropathic psoriasis. [3] Repots of complicated cataracts are extremely rare and are probably coincidental. [4] We report here a case of psoriasis associated with unilateral uveitis but without arthritis.


  Case Report Top


A 22-year old man presented with complaints of redness and scaling over the skin in upper and lower limbs, scalp and trunk for the past 8 months. The patient had pain, redness, watering and intolerance to light in the right eye for 2 days. The patient was in perfect health 8 months ago, when he developed a red and scaly, pruritic patch on the right forearm. Subsequently, new lesions appeared over the trunk, limbs and scalp in two months. There was no history of redness, swelling, or pain in any of the joints. The patient noticed redness in right eye which gradually increased and was associated with watering, pain and inability to tolerate light. The left eye remained asymptomatic. The patient neither had trauma to his eyes nor any ulcer over the genitalia. No discharge was noticed by him from the urethra. The patient was teatotaller. All his family members were healthy. The examination of skin revealed well defined, erythematous, scaly, papules and plaques of varying sizes and shapes present over the neck, upper and lower limbs, chest, abdomen and the back. The scales were micaceous. Auspitz sign was positive. The right eye of the patient had circumcorneal congestion, tenderness and watering. Photophobia was also present.

The slit lamp examination revealed flare cells, keratitic precipitates, posterior synechiae and pig­ments near the anterior surface of the lens. The left eye was normal. Ophthalmoscopy of both eyes revealed no abnormality of the retina.

The various biochemical investigations viz. blood glucose, urea, serum proteins, serum creatinine and electrolytes were within normal limits. Rheumatoid factor, LE cell phenomenon, antinuclear factor and VDRL were negative. His haemoglobin was 14 gm%, TLC was 11,900/cu. mm, polymorphs 70, lymphocytes 20, eosinophils 5, and ESR 30 mm in first hour. Routine and microscopic examination of urine was normal. Skeletal survey did not reveal any abnormality. HLA B27 was negative.


  Discussion Top


The onset of disease was at 22 years of age in this patient while the patients reported earlier were above 45 years of age. [2] Uveitis has been detected earlier in patients of psoriatic arthropathy, ankylosing spondylitis and Reiter's disease. [1] In Reiter's disease eye involvement, non-gonococcal urethritis, keratoderma blenorrhagicum and lesions on palms and soles may occur. No such features were present in this patient. These patients had increased incidence of HLA B27. [2] In our case HLA B27 was not detected.

There was neither clinical nor radiological evidence of arthropathy in this patient. The possibility of arthropathic psoriasis was not considered keeping in view of the absence of arthralgia clinically, normal skiagrams and absence of HLA B27. So far uveitis in psoriasis patients has been reported in association with arthropathy and increased incidence of HLA B 27. This patient of generalised plaque type psoriasis is entirely different from earlier reported cases of uveitis in that he had non arthritis, and HLA B27 was absent.



 
  References Top

1.Camp RDR. Psoriasis. In: Champion RH, Burton JL, Ebling FJG, Editors. Textbook of Dermatology 5 thsub edition, Oxford; Blackwell Scientific Publications, 1992;1391-457.  Back to cited text no. 1    
2.Catsaroucatsari A, Katsambas A, Theodoropoulos P, et al. Oph­thalmological manifestations in patients with psoriasis. Acta Derm Venereol 1984;64:557-9.  Back to cited text no. 2    
3.Collier MM. Les Modifications Der Cristallin Chez Les Porteurs De Psoriasis, Bull Soc Ophthalmol Fr 1962;62:59.  Back to cited text no. 3    
4.Kaldeck R. Ocular psoriasis. Arch Dermatol (suppl) 1953;68:44.  Back to cited text no. 4    




 

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