RESUMO
We report four cases of corneoconjunctival keratinization that were successfully treated with topical retinoic acid ointment. In two cases keratinization was due to squamous metaplasia and in two others it was secondary to intraepithelial corneoconjunctival neoplasia. Treatment reversed severe keratinization in a case of drug-induced pseudopemphigoid and stabilized the disease in one of the two affected eyes without additional treatment. In a case of ocular cicatricial pemphigoid, retinoic acid was useful as an adjuvant therapy to immunosuppression, by reversing keratinization of the conjunctiva. In two cases of corneoconjunctival neoplasia, lesions regressed markedly. Long-term treatment was well tolerated in three patients. Our findings suggest that retinoic acid ointment is effective in treating severe squamous metaplasia in cicatrizing diseases of the conjunctiva. Our findings indicate further that retinoic acid seems to inhibit growth of corneoconjunctival neoplasias and thus might be useful complementary therapy in this situation.
Assuntos
Túnica Conjuntiva/metabolismo , Doenças da Túnica Conjuntiva/tratamento farmacológico , Córnea/metabolismo , Doenças da Córnea/tratamento farmacológico , Queratinas/metabolismo , Tretinoína/uso terapêutico , Administração Tópica , Idoso , Idoso de 80 Anos ou mais , Doenças da Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/tratamento farmacológico , Conjuntivite/tratamento farmacológico , Conjuntivite/patologia , Doenças da Córnea/patologia , Epitélio/metabolismo , Epitélio/patologia , Feminino , Humanos , Masculino , Metaplasia/tratamento farmacológico , Tretinoína/administração & dosagemRESUMO
A case of drug-induced ocular cicatricial pemphigoid with pronounced keratinizing squamous epithelium metaplasia was treated for 5 months with all-trans retinoic acid ointment. Keratinization reversed completely and the cicatricial process was stabilized in one eye and slowed down in the other eye. The treatment was well tolerated.