Which conditions are included in the differential diagnoses of peripheral ulcerative keratitis (PUK)?

Updated: Jun 11, 2019
  • Author: Ellen N Yu-Keh, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

The differential diagnosis of PUK is outlined below. [4]

  • Noninfectious conditions

    • Systemic - RA, SLE, RP, sarcoidosis, progressive systemic sclerosis, rosacea, GPA, PAN, juvenile idiopathic arthritis, [16] giant cell arteritis, Behçet disease, [17] inflammatory bowel disease, pyoderma gangrenosum, [18] metabolic conditions, nutritional deficiencies, and drug-induced side effect (checkpoint inhibitor ipilimumab) [19]

    • Local - Mooren ulcer, marginal keratitis, blepharitis (eg, staphylococcal infection, rosacea), contact lens use, chemical injury to the eyes, [20] trauma, neurotrophic and neuroparalytic causes, keratoconjunctivitis sicca, Terrien marginal degeneration, pellucid marginal degeneration, and furrow degeneration [5]

    • Surgery - Trabeculectomy, [21] cataract surgery [22]

  • Infectious conditions

    • Systemic -Shigella species, tuberculosis, syphilis, hepatitis, HIV, gonococcus, Salmonella species, and bacillary dysentery

    • Local - Herpes simplex keratitis, varicella-zoster keratitis, bacterial keratitis, fungal keratitis, and Acanthamoeba species

  • Masquerade - Malignancy - Leukemia [23, 24]


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