1/7. Ocular rosacea in childhood.PURPOSE: To describe the clinical characteristics and treatment response of ocular rosacea in the pediatric population. DESIGN: Retrospective case series. methods: The clinic charts of consecutive pediatric cases of ocular rosacea were evaluated over a 34-month period. Minimal diagnostic inclusion criteria were the presence of posterior eyelid inflammation including meibomian gland inspissation and lid margin telangiectasis, in conjunction with conjunctival injection or episcleritis. RESULTS: Six patients ranged from 3 to 12 years of age at presentation. All shared a long history of ocular irritation and photophobia. Five patients (83%) were female and had bilateral involvement. Eyelid telangiectases and meibomian gland disease were present in all cases. Three patients (50%) had sterile corneal ulcers. Only two patients (33%) had cutaneous involvement at the time of diagnosis. All patients experienced significant improvement with a combination of oral antibiotics (doxycycline or erythromycin), with or without topical antibiotics (erythromycin or bacitracin) or topical steroids (fluorometholone). CONCLUSION: Ocular rosacea in children may be misdiagnosed as viral or bacterial infections. Unlike in adults, associated cutaneous changes are uncommon. Most disease is bilateral, although involvement may be asymmetric. Response to conventional treatment is excellent, although long-term treatment may be necessary to prevent relapses.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/7. Pediatric ocular acne rosacea: long-term treatment with systemic antibiotics.PURPOSE: To report our experience with four cases of pediatric ocular acne rosacea, including responses to long-term systemic treatment. DESIGN: Retrospective interventional case series. methods: The medical records of four consecutive cases diagnosed with pediatric ocular acne rosacea over a period of 36 months were reviewed. Diagnostic criteria were meibomian gland dysfunction, blepharitis, lid margin telangiectasia, punctate superficial keratopathy, and conjunctival hyperemia with or without inferior corneal vascularization. RESULTS: The patients, aged between four and 12, were all females with bilateral disease. Meibomitis, blepharitis, conjunctival hyperemia, and punctuate epitheliopathy was evident in each case. Cutaneous involvement was seen in two cases (50%), and limbal vascularization with subepithelial or stromal infiltrates was present in three cases (75%). One case showed corneal ulceration at presentation. All four children received systemic doxycycline or erythromycin for at least 12 months and showed considerable improvement within the first month of therapy. No recurrence was noted within the mean 25.5 months of follow-up. None of the girls experienced any side effects during the long treatment duration. CONCLUSIONS: Ophthalmologists should consider acne rosacea as a potential diagnosis for any child who has any combination of meibomian disease, chronic blepharitis, recurrent chalazia, and chronic symptoms of photophobia, ocular irritation, and redness that does not respond to routine medical treatment. Such patients respond very well to long-term treatment with systemic erythromycin/doxycycline.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
3/7. Surgical management of extensive gnathophyma.rhinophyma is an uncommon disease of the nose characterized by irregular skin thickening and nodular deformation. The extensive growth causing 'whisky nose' is due to hyperplasia of the sebaceous glands and the surrounding connective tissue. Other facial regions may concomitantly be affected. We present a case of extensive gnathophyma accompanying minor lesions of the nose. Surgical treatment led to an excellent cosmetic result.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
4/7. methods and complications of rhinophyma excision.For years cosmetic surgeons have sought methods of treatment of large rhinophyma. These include creation of flaps with excision of excess skin, dermabrasion, free-hand shave, and others. The CO2 laser has been used by itself, or in combination with other methods to vaporize the rhinophyma. Advantages of the the laser include hemostasis, better view of the tissues, thin layer-by-layer removal of the hyperplastic sebaceous glands, and careful shaping of the resection edges. Disadvantages include risk of facial burns and overabundant removal of tissue with cartilage exposure. We present a case of rhinophyma excision using the CO2 laser and the complication of excessive vaporization of the sebaceous tissue. Included is a discussion of other complications of laser excision of rhinophyma, possible methods of reconstruction, and a literature review.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
5/7. The black thyroid. Its relation to minocycline use in man.We studied a patient with a grossly black thyroid gland considered to be related to minocycline therapy. Microscopically, a brown granular pigment was localized in follicular cells and colloid, which histochemically was melanin or a melaninlike substance. Ultrastructurally, the pigment is confined to lysosomes. The pigment seems to be either an oxidative degradation product of the drug itself, or the results of an as yet unknown alteration of tyrosine metabolism by the drug. Although minocycline is known to interfere with thyroid function in animals, no evidence has been presented for such an effect in humans. The occurrence of a black thyroid gland in humans seems to be virtually pathognomonic for long-term minocycline therapy.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/7. Folliculosebaceous cystic hamartoma associated with rosacea.A case of folliculosebaceous cystic hamartoma associated with rosacea is presented. Clinically, a solid, 5-mm-sized nodule was observed on the nose which showed telangiectasia and a waxy appearance. Histologically, a large horn cyst was located in the dermis, and was continuous with the surface epidermis. It was associated with mature sebaceous glands and immature hair follicles. Folliculosebaceous cystic hamartoma and similar cases have recently been reported, but this is the first report accompanied by rosacea.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
7/7. Acne rosacea with keratitis in childhood.We present three cases of acne rosacea keratitis that developed in childhood. All three children were prepubescent and demonstrated characteristic dermatologic findings involving the nose, cheeks, and/or chin. The patients had complained of ocular irritation for at least 6 months, and in one case symptoms were reported by the family to have occurred intermittently since age 4 years. All three children showed evidence of meibomian gland inflammation; two patients demonstrated bilateral keratitis, the third had only unilateral involvement. In each case, oral tetracycline hydrochloride or doxycycline hyclate was necessary to relieve symptoms. rosacea keratitis should be considered in the differential diagnosis of chronic keratoconjunctivitis during childhood.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |