PMC10220430_01
Clinical appearance of skin rash. (a) Facial rash with firm pustules over the periocular, perinasal, and perioral areas (b) Brown papules left on the bilateral skin of the arms after rash (c) Erythematous papules present at bilateral legs and feet (d) Face skin biopsy showed one granuloma with central microabscess (circle), and one necrosis with empty vacuoles surrounded by histiocytes (10x)
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F1
Three months before consultation, her facial rash with pustules progressed and developed more severely than ever [Figure 1a-c]. C3 immunocomplex at dermoepidermal junction, which was consistent with GR [Figure 1d]. Chest X-ray showed increased perihilar infiltration on both lungs.
Clinical appearance of the right cornea before and after treatment (a) Initial slit-lamp examination of the right eye presenting PUK at the 36 o'clock area with stromal thinning and cells in the anterior chamber with flare and iris pigments (b) Primary repair of perforated peripheral ulcerative keratitis with glycerol cornea (c) One month after glycerol cornea repair. The corneal graft was in situ with negative Seidel test (d) Inferonasal corneal graft with 1 stitch before removal of 9 months after repair. The anterior chamber was shallow and clear. No perforation, neovascularization, or inflammation was noted
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F2
Slit-lamp examination revealed major abnormalities in the right eye: diffuse hyperemia in the conjunctiva and episclera, perilimbal 3 to 6 o'clock circumferential stromal thinning in the cornea without infiltrate, lipid deposit or vessel ingrowth, and 2+ cells (moderate) in the anterior chamber with flare and iris pigments [Figure 2a]. The emergent repair was performed with a glycerol-preserved corneal graft [Figure 2b].