Herpes Simplex Blepharitis of the Erosive-Ulcerative Type

Summary

In contrast to the classical picture of herpes simplex infection involving the lids and lid margin characterized by the presence of a group of vesicles situated on a swollen erythematous base, the latter are usually lacking in the erosive-ulcerative type of herpes simplex blepharitis (Fig. 1, 2). Here the following features are encountered: single or multiple intermarginal erosions, single or multiple skin ulcers situated at the lid margin, or a combination of both. The affected lid portion usually exhibits slight swelling and tenderness upon palpation, moderate conjunctival injection especially adjacent to the lesion may be present, as well as ipsilateral palpable lymph nodes. A total of 42 cases has been observed within a period of 3 years. From the initial 28 patients smears were obtained for immunological proof of our diagnosis, which turned out to be positive in 26 cases, testifying to the reliability of the clinical features, which have been outlined in detail in our previous papers (Klin Monatsbl Augenheilkd 173:407–412 (1978), Arch Ophthalmol (in press)). In about 20% of the cases proven herpes simplex conjunctivitis has been encountered; therefore, local virustatics should be applied to the lesions as well as conjunctiva, especially in view of the fact that these drugs will find ready access to the viruses within the erosions and ulcers.

Zusammenfassung

Die Herpes simplex-Blepharitis vom erosiv-ulzerösen Typ äußert sich in Form von einzelnen oder multiplen Erosionen im Bereiche des intermarginalen Saumes oder Ulzera nahe dem Lidrand oder einer Kombination beider Formen (Abb. 1, 2). Nur ausnahmsweise können auch gleichzeitig charakteristische Herpesbläschen in unmittelbarer Umgebung registriert werden. Da die Ausbreitung der Viren auf die benachbarte Bindehaut ungehindert erfolgen kann, sollten hier unbedingt lokale Virustatika angewandt werden.