Limited Cutaneous Systemic Sclerosis Presenting with Corneal Melt: A Complication of Uncontrolled Disease

Abstract

Limited cutaneous systemic sclerosis is an autoimmune condition with an abnormal proliferation in connective tissue proliferation. Corneal melt is caused by breakdown of corneal collagen which may be caused by various etiologies including inflammatory, infectious, and trauma have been linked to corneal melt. Corneal melt is rarely caused by autoimmune conditions including rheumatoid arthritis, vasculitis, systemic lupus erythematosus, relapsing polychondritis, and systemic sclerosis. We present an 83-year-old female hispanic patient with history of peripheral vascular disease who presented with corneal melt. Patient’s clinical history as well as labs, specifically anti-centromere antibody were consistent with limited cutaneous systemic sclerosis. Patient was started on treatment with Rituximab for the management of corneal melt associated with systemic sclerosis, which resulted in improvement of the corneal melt as well as symptoms of systemic sclerosis. Careful attention needs to be placed on the etiology of the corneal melt in order to prevent disease progression. The key to treatment of corneal melt is treatment of the underlying cause. Appropriate treatment and identification of corneal melt is paramount to prevention of permanent visual loss.