Severe exposure keratopathy secondary to oncologic surgery in a patient with epidermodysplasia verruciformis

Abstract

The case of a 43-year-old woman who presented with multiple exophytic lesions on both eyelids of the left eye is described. The patient underwent excisional biopsy of the lesions, and later 2 more interventions were necessary for the excision of the affected margins. She was followed by dermatology and medical oncology specialists, as she presented several skin tumors in other locations. Two years after the intervention, she developed a lower corneal abscess in the left eye, with cultures positive for Candida spp. Approximately 12 months later, the infection had completely resolved, leaving a leukoma with both superficial and deep vascularization in the lower cornea. Lagophthalmos was observed along with a predominantly lateral cicatricial ectropion of the lower eyelid, accompanied by increased corneal vascularization, lipoid degeneration, and greater central opacity. The patient underwent cauterization of the superficial vessels and intrastromal bevacizumab injection into the deep vessels and has now been offered penetrating keratoplasty. Epidermodysplasia verruciformis is a rare skin condition characterized by the development of squamous cell carcinomas and flat warts. When these lesions involve the eyelid, close communication between dermatologists, corneologists, and oculoplastic surgeons is essential for optimal management of these patients.