In this Image in Clinical Medicine from NEJM, erosions and ulcers are seen on the left lower eyelid of a man.
Comment
The authors describe a healthy young man presenting with recurrent painful umbilicated erosions and ulcers on an erythematous base on the medial aspect of his left lower eyelid since he was a teenager. PCR from a lesion confirmed herpes simplex virus (HSV) blepharitis.
The differential diagnosis for the lesions seen on this patient can include atopic dermatitis or other infections, such as herpes zoster ophthalmicus. Although HSV blepharitis can occur in isolation as it did with this patient, clinicians should look for involvement of other ocular structures, since HSV keratitis, uveitis, and retinitis can cause blindness.
Comment
The authors describe a healthy young man presenting with recurrent painful umbilicated erosions and ulcers on an erythematous base on the medial aspect of his left lower eyelid since he was a teenager. PCR from a lesion confirmed herpes simplex virus (HSV) blepharitis.
The differential diagnosis for the lesions seen on this patient can include atopic dermatitis or other infections, such as herpes zoster ophthalmicus. Although HSV blepharitis can occur in isolation as it did with this patient, clinicians should look for involvement of other ocular structures, since HSV keratitis, uveitis, and retinitis can cause blindness.