Conjunctival squamous metaplasia on amniotic membrane in Stevens-Johnson syndrome: a case report
Abstract Background To present a case of conjunctival growth on the amniotic membrane and subsequent pathology revealing conjunctival squamous metaplasia in a patient with Stevens-Johnson syndrome. Case presentation A 21-year-old female presented with painful, blurred vision in both eyes for two wee...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-11-01
|
| Series: | BMC Ophthalmology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12886-024-03700-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850196505426657280 |
|---|---|
| author | Yung-Kang Chen Chen-Lin Chi Chien-Hsiung Lai Pei-Lun Wu |
| author_facet | Yung-Kang Chen Chen-Lin Chi Chien-Hsiung Lai Pei-Lun Wu |
| author_sort | Yung-Kang Chen |
| collection | DOAJ |
| description | Abstract Background To present a case of conjunctival growth on the amniotic membrane and subsequent pathology revealing conjunctival squamous metaplasia in a patient with Stevens-Johnson syndrome. Case presentation A 21-year-old female presented with painful, blurred vision in both eyes for two weeks. She was diagnosed with Stevens-Johnson syndrome 5 weeks before. Due to bilateral corneal epithelial defects, ProKera®, an amniotic membrane corneal bandage with a polycarbonate ring, was placed in both eyes. However, three weeks later, a slit-lamp examination revealed vascularized tissue growth from the palpebral conjunctiva to the amniotic membrane, along with symblepharon formation in the left eye. The patient underwent conjunctival biopsy, amniotic membrane removal, and symblepharon release. Pathology report showed the growth of squamous epithelium on the acellular amniotic membrane. Immunohistochemistry further supported the diagnosis, revealing squamous markers through p40 staining and highlighting the presence of the amniotic membrane using trichrome stain. Three months later, the patient’s visual acuity had improved to 20/25 and no symblepharon was noted. Conclusions This is the first case of conjunctival squamous metaplasia on amniotic membrane associated with Stevens-Johnson syndrome. Our case indicates that, despite the anti-inflammatory properties of amniotic membrane, conjunctival squamous metaplasia may arise after amniotic membrane grafting due to intense inflammation in Stevens-Johnson syndrome. Clinicians should conduct regular monitoring before amniotic membrane dissolution to preclude the development of conjunctival squamous metaplasia on the membrane and potential invasion into the cornea. |
| format | Article |
| id | doaj-art-240bc9f3026547839efb0617cb82aa49 |
| institution | OA Journals |
| issn | 1471-2415 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj-art-240bc9f3026547839efb0617cb82aa492025-08-20T02:13:27ZengBMCBMC Ophthalmology1471-24152024-11-012411510.1186/s12886-024-03700-6Conjunctival squamous metaplasia on amniotic membrane in Stevens-Johnson syndrome: a case reportYung-Kang Chen0Chen-Lin Chi1Chien-Hsiung Lai2Pei-Lun Wu3Department of Ophthalmology, Chiayi Chang Gung Memorial HospitalDepartment of Pathology, Chiayi Chang Gung Memorial HospitalDepartment of Ophthalmology, Chiayi Chang Gung Memorial HospitalDepartment of Ophthalmology, Chiayi Chang Gung Memorial HospitalAbstract Background To present a case of conjunctival growth on the amniotic membrane and subsequent pathology revealing conjunctival squamous metaplasia in a patient with Stevens-Johnson syndrome. Case presentation A 21-year-old female presented with painful, blurred vision in both eyes for two weeks. She was diagnosed with Stevens-Johnson syndrome 5 weeks before. Due to bilateral corneal epithelial defects, ProKera®, an amniotic membrane corneal bandage with a polycarbonate ring, was placed in both eyes. However, three weeks later, a slit-lamp examination revealed vascularized tissue growth from the palpebral conjunctiva to the amniotic membrane, along with symblepharon formation in the left eye. The patient underwent conjunctival biopsy, amniotic membrane removal, and symblepharon release. Pathology report showed the growth of squamous epithelium on the acellular amniotic membrane. Immunohistochemistry further supported the diagnosis, revealing squamous markers through p40 staining and highlighting the presence of the amniotic membrane using trichrome stain. Three months later, the patient’s visual acuity had improved to 20/25 and no symblepharon was noted. Conclusions This is the first case of conjunctival squamous metaplasia on amniotic membrane associated with Stevens-Johnson syndrome. Our case indicates that, despite the anti-inflammatory properties of amniotic membrane, conjunctival squamous metaplasia may arise after amniotic membrane grafting due to intense inflammation in Stevens-Johnson syndrome. Clinicians should conduct regular monitoring before amniotic membrane dissolution to preclude the development of conjunctival squamous metaplasia on the membrane and potential invasion into the cornea.https://doi.org/10.1186/s12886-024-03700-6Conjunctival squamous metaplasiaAmniotic membraneStevens-Johnson syndromeProKera |
| spellingShingle | Yung-Kang Chen Chen-Lin Chi Chien-Hsiung Lai Pei-Lun Wu Conjunctival squamous metaplasia on amniotic membrane in Stevens-Johnson syndrome: a case report BMC Ophthalmology Conjunctival squamous metaplasia Amniotic membrane Stevens-Johnson syndrome ProKera |
| title | Conjunctival squamous metaplasia on amniotic membrane in Stevens-Johnson syndrome: a case report |
| title_full | Conjunctival squamous metaplasia on amniotic membrane in Stevens-Johnson syndrome: a case report |
| title_fullStr | Conjunctival squamous metaplasia on amniotic membrane in Stevens-Johnson syndrome: a case report |
| title_full_unstemmed | Conjunctival squamous metaplasia on amniotic membrane in Stevens-Johnson syndrome: a case report |
| title_short | Conjunctival squamous metaplasia on amniotic membrane in Stevens-Johnson syndrome: a case report |
| title_sort | conjunctival squamous metaplasia on amniotic membrane in stevens johnson syndrome a case report |
| topic | Conjunctival squamous metaplasia Amniotic membrane Stevens-Johnson syndrome ProKera |
| url | https://doi.org/10.1186/s12886-024-03700-6 |
| work_keys_str_mv | AT yungkangchen conjunctivalsquamousmetaplasiaonamnioticmembraneinstevensjohnsonsyndromeacasereport AT chenlinchi conjunctivalsquamousmetaplasiaonamnioticmembraneinstevensjohnsonsyndromeacasereport AT chienhsiunglai conjunctivalsquamousmetaplasiaonamnioticmembraneinstevensjohnsonsyndromeacasereport AT peilunwu conjunctivalsquamousmetaplasiaonamnioticmembraneinstevensjohnsonsyndromeacasereport |