Eyelid involvement in disseminated chronic cutaneous lupus erythematosus.

Eye involvement in chronic cutaneous lupus erythematosus (CCLE) has been reported infrequently. We describe two cases of disseminated CCLE, a 50-year-old woman and a 45-year-old man, with eyelid involvement and disease duration of 4 and 20 years respectively. The first patient showed an excellent response to chloroquine while there was lack of response in the second patient.

Hypopigmented face patches; their distribution and relevance to ocular complications in leprosy.

Eighty-two leprosy patients with hypopigmented patches over the face (cases) and an equal number of age-, sex-, and classification-matched leprosy patients without any hypopigmented patches over the face (controls) were examined for the distribution of hypopigmented facial patches, areas of anesthesia over the face, and eye complications. The hypopigmented patches did not follow any pattern and overlapped in the areas of sensation supplied by the three branches of the trigeminal nerve. Anesthesia over the face, evaluated by a Semmes-Weinstein monofilament which exerted a force of 0.05 grams, was present in 19.5% of the cases and 15.9% of the controls. Patients with hypopigmented facial patches were found to have more corneal hypoesthesia than patients who did not have hypopigmented facial patches. The risk of having impaired corneal sensation was three to four times higher in patients with hypopigmented facial patches. This feature can be used to identify decreased corneal sensation among leprosy patients under field conditions where direct estimation of corneal sensation is not advocated.

Paralysis of facial muscles in leprosy patients with lagophthalmos.

The objective of the study was to determine the pattern of involvement of facial muscles in lagophthalmos. Fifty-seven patients with lagophthalmos were examined to assess the degree of paralysis of facial muscles. Eighty-one percent of the patients with lagophthalmos had involvement of at least one other muscle group. In patients with lagophthalmos with a gap at mild closure of 5 mm or more, 27 of 30 (90%) had involvement of at least one other facial muscle. In lepromatous leprosy the pattern of involvement was symmetrical and "patchy," the right and left sides being affected equally. In tuberculoid leprosy, the ipsilateral muscles were more often involved, which is the pattern of involvement of a nerve trunk. The upper and lower facial muscles were affected in the same proportion. Hence, on clinical grounds, there is little support for the often postulated statement that the superficial course of the facial nerve above the zygomatic bone is decisive for exclusive paralysis of the zygomatic branch of the facial nerve.

A survey on eye involvement among leprosy patients in The Netherlands.

A survey of 121 leprosy patients in the Netherlands showed eye involvement in 20% of the patients, rising to 27% if madarosis and the adnexae are included. Iris atrophy was the main lesion encountered in BL and LL patients. One typical lepromatous fundus lesion was seen. No bilateral blindness occurred. Two eyes had a visual acuity of 3/60 due to intractable scleritis and acute iritis in LL with ENL. Seven eyes of 5 patients had a visual acuity of 0.2 to 3/60, mainly due to iris atrophy in lepromatous leprosy. Prevalence of blindness in our series was low as compared with the literature.

[Ocular lesions in lepromatous leprosy (author's transl)]. / Les lésions oculaires de la lèpre lépromateuse.

Ocular lesions observed in III cases of lepromatous or borderline leprosy are described. Tables are included which indicate the visual acuity, corneal sensitivity, and lesions noted in the appendages. Particular attention is paid to lesions in the pars plana, which include true posterior cyclitis having the appearance of "ants eggs" or "pearls" deposits on the retina, associated with vascular lesions and peripheral hyalitis. The absence of associated mucular edema is strongly emphasized. The etiopathogenicity of lesions of this type is probably directly related to leprous erythema nodosum. Detailed studies should be conducted on the chronological stages of these affections and their subsequent progression.