CHRONIC UNILATERAL KERATOCONJUNCTIVITIS DUE TO MOLLUSCUM CONTAGIOSUM OF THE UPPER LID MARGIN

Patient and methods: Over a period of one year a 33-year-old married housewife, mother of two healthy children, complained of an initially recurrent, in the last 6 months persisting conjunctivitis, upper and lower lid edema, dacryorrhea and photophobia concerning the left eye. Neither topical derivates of cromoglycin acid, antibiotics nor steroids brought relief. Half a year ago the patient had noticed a 'little nodule' of the lateral upper eyelid without tendency to grow. The visual acuity was 0.8 due to a punctate superficial keratopathy. In addition a marked follicular conjunctivitis was present. Our examination revealed a little whitish-rosy tumor with elevated edges and a central crater at the lateral margin of the upper lid. The right eye was completely normal. The tumor was totally excised preserving the lid margin. Our histopathological diagnosis was 'molluscum contagiosum'. Four weeks after surgery the keratoconjunctivitis had subsided without further medication. Conclusion: In persisting unilateral conjunctivitis without amelioration after any topical therapy the eyelids should be checked carefully for a tumor to be excised. In older patients a sebaceous gland carcinoma must be ruled out. Considering the patient's personal history a chlamydial infection should be kept in mind as a differential diagnosis.