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Question: Can you identify this condition?

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Vol 58: MAy • MAi 2012

|

Canadian Family Physician•Le Médecin de famille canadien

537

Dermacase Ophthaproblem

Answer on page 540 Answer on page 538

Can you identify this condition?

Yu-Wen Yeh

MD

Yu-Fei Chen

MD

Bai-Yao Wu

MD

A

40-year-old man presented with a 3-month history of progressive skin eruption on the extensor surface of his extremities, including the forearms, elbows, and knees. The lesions were discrete, asymptomatic, yellow- ish papules to nodules. A biochemical profile revealed hyperglycemia and hypertriglyceridemia.

The most likely diagnosis is 1. Sarcoidosis

2. Langerhans cell histiocytosis 3. Eruptive xanthomas

4. Molluscum contagiosum 5. Acute generalized

exanthematous pustulosis

Can you identify this condition?

Kunyong Xu

MPH

Vishal Jhanji

MD

A

n 11-year-old boy presented with a chronic his- tory of itching and watering eyes, photophobia, and marked redness in both eyes. On examination, vis- ual acuity was 20/20 for both eyes. Slit lamp exam- ination revealed a shield ulcer with a clear base on the right cornea (Figure 1A). The left cornea had a shield ulcer with a similar clinical picture (Figure 1B). Right eyelid eversion revealed papillae under the lid (arrow, Figure 1C). Lid eversion of the left eye showed papillae after staining with 1% sodium fluorescein dye (arrow, Figure 1D). There was no evidence of corneal infiltra- tion and the anterior chamber was quiet in both eyes.

The intraocular pressure was 14 mm Hg in each eye.

There was no history of systemic allergy, allergic bron- chitis, or skin allergy.

The most likely diagnosis is

1. Vernal keratoconjunctivitis with shield ulcers

2. Atopic keratoconjunctivitis

3. Fibrosing conjunctivitis

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