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Atopische Keratokonjunktivitis

Wahrscheinlich ein Risikofaktor für die Entstehung von Bindehautkarzinomen

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Zusammenfassung

Hintergrund

Nahezu die Hälfte der Patienten mit atopischer Dermatitis erkrankt im Laufe des Lebens an chronischen Entzündungen von Lidern, Bindehaut und Hornhaut. Chronische Entzündungen können zur Entwicklung von Dysplasien und Malignomen prädisponieren, besonders wenn sie mit Immundefekten einhergehen, wie dies bei atopischer Dermatitis der Fall ist. Bisher ist noch keine Korrelation zwischen einer atopischen Keratokonjunktivitis und einer konjunktivalen Neoplasie beschrieben worden. Wir berichten über 7 Atopiker, bei denen zwischen Februar 2000 und August 2001 ein konjunktivales Karzinom oder ein Carcinoma in situ diagnostiziert wurden.

Patienten

Alle 7 Patienten wiesen eine langjährige Anamnese sowohl hinsichtlich der atopischen Dermatitis als auch einer chronischen Bindehaut- und Hornhautbeteiligung auf. Die Diagnostik umfasste bei allen 7 Patienten zytologische und zytometrische Untersuchungen von konjunktivalen Bürstenabstrichen. Bei 6 der 7 Patienten wurde außerdem konjunktivales Biopsiematerial histopathologisch untersucht.

Ergebnisse

Bei 4 der 7 Patienten wurden invasive Bindehautkarzinome festgestellt. Zwei Patienten wiesen ein Carcinoma in situ auf. Ein Patient mit zytologisch/zytometrisch nachgewiesenem Bindehautkarzinom oder Carcinoma in situ verweigerte die Exzision, sodass eine histopathologische Untersuchung nicht möglich war.

Schlussfolgerungen

Diese Ergebnisse sprechen dafür, dass für Patienten mit atopischer Keratokonjunktivitis ein erhöhtes Risiko für die Entwicklung von Bindehautkarzinomen besteht.

Abstract

Background

Almost half of the patients with atopic dermatitis experience chronic inflammation of the eyelids, the conjunctiva and the cornea. Chronic inflammation is a possible cause for the development of malignancies, especially if associated with some kind of immunological defect as in atopic patients. So far, a correlation between atopic conjunctivitis and conjunctival malignancies has not yet been reported. Here, we present 7 atopic patients with conjunctival carcinoma or carcinoma in situ detected between February 2000 and August 2001.

Patients

All 7 patients had a long history of atopic dermatitis and chronic of inflammation of the conjunctiva and cornea. In all patients smears were examined by cytology and DNA cytometry. Furthermore, in 6 of the 7 patients a histopathological examination of conjunctival biopsies was performed.

Results

In 4 of the 7 patients invasive conjunctival carcinoma and in 2 carcinoma in situ were detected. Cytology and cytometry revealed conjunctival carcinoma or carcinoma in situ in the remaining patient. Histopathological examination could not be performed since the patient refused to have a conjunctival biopsy.

Conclusions

These results suggest that atopic keratoconjunctivitis might be a risk factor for the development of conjunctival carcinoma.

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Author information

Authors and Affiliations

  1. Augenklinik der Heinrich-Heine-Universität Düsseldorf

    C. Kallen, G. Schilgen, O. Cartsburg & R. Sundmacher

  2. Universitäts-Augenklinik Freiburg

    T. Reinhard & C. Auw-Hädrich

  3. Institut für Cytopathologie der Heinrich-Heine-Universität Düsseldorf

    A. Böcking

  4. Universitäts-Augenklinik Freiburg, Killianstraße 5, 79106, Freiburg

    T. Reinhard

Authors
  1. C. Kallen
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  2. T. Reinhard
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  3. G. Schilgen
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  4. O. Cartsburg
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  5. A. Böcking
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  6. C. Auw-Hädrich
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  7. R. Sundmacher
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Correspondence to T. Reinhard.

Additional information

Poster während der Tagung der DOG in Berlin im Jahr 2001.

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Kallen, C., Reinhard, T., Schilgen, G. et al. Atopische Keratokonjunktivitis. Ophthalmologe 100, 808–814 (2003). https://doi.org/10.1007/s00347-003-0809-z

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