Bilateral Cicatricial Ectropion on Necrotising Fasciitis: A Case Report
M. Chnaoui *
Adults’ Ophthalmology Department Hospital August 20, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca Casablanca, Morocco.
A. Arazzakou
Adults’ Ophthalmology Department Hospital August 20, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca Casablanca, Morocco.
A. Hammouche
Adults’ Ophthalmology Department Hospital August 20, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca Casablanca, Morocco.
MR. Bentouhami
Adults’ Ophthalmology Department Hospital August 20, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca Casablanca, Morocco.
Y. Hidane
Adults’ Ophthalmology Department Hospital August 20, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca Casablanca, Morocco.
A. Mchachi
Adults’ Ophthalmology Department Hospital August 20, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca Casablanca, Morocco.
L. Benhmidoune
Adults’ Ophthalmology Department Hospital August 20, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca Casablanca, Morocco.
R. Rachid
Adults’ Ophthalmology Department Hospital August 20, Faculty of Medicine and Pharmacy, Ibn Rochd University Hospital, Casablanca Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Necrotising fasciitis is a severe infection of the subcutaneous tissue and superficial fascia, associated with necrosis of the overlying skin tissue. Periorbital involvement is rare. It can be responsible for multiple early deleterious complications and late cicatricial ones, such as ectropion.
Case Presentation: We report the case of a 69-year-old patient, hypertensive and poorly controlled diabetic, with a history of hospitalisation for bilateral palpebrojugal Necrotising fasciitis on maxillary sinusitis. The examination found visual acuity at 6/10 in ODG, with severe bilateral ectropion, associated with adhesions, a more marked KPS in the inferior, a good anterior chamber, a round and regular pupil, and a posterior cortical and subcapsular cataract. The posterior segment was normal.
Discussion: Ectropion is the most common eyelid malposition; it is an eyelid eversion associated with conjunctival and corneal exposure, more frequently affecting the lower eyelid. It can be congenital or acquired; the latter is classified according to the causal mechanism as involutional, paralytic, cicatricial, or mechanical. Management depends on the type of damage, with focal damage treated by excision of scar tissue and severe damage requiring transposition flaps or full skin grafts.
Conclusion: Several conditions can cause cicatricial ectropion; periorbital Necrotising fasciitis is one of them, requiring protective medical and restorative surgical management.
Keywords: Necrotising fasciitis, surgical management, ectropion, maxillary sinusitis