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Treatment of conjunctival papilloma with topical interferon alpha-2b - case report

RATIONALE: Conjunctival papilloma is a benign neoplastic lesion of epithelial origin, with a minimal tendency toward malignancy and an exophytic growth type. Etiological factors that contribute to the appearance of papilloma are UV exposure, HPV infection, smoking, and immunodeficiency. A case repor...

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Autores principales: Bolek, Bartłomiej, Wylęgała, Adam, Teper, Sławomir, Kokot, Joanna, Wylęgała, Edward
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035065/
https://www.ncbi.nlm.nih.gov/pubmed/32049852
http://dx.doi.org/10.1097/MD.0000000000019181
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author Bolek, Bartłomiej
Wylęgała, Adam
Teper, Sławomir
Kokot, Joanna
Wylęgała, Edward
author_facet Bolek, Bartłomiej
Wylęgała, Adam
Teper, Sławomir
Kokot, Joanna
Wylęgała, Edward
author_sort Bolek, Bartłomiej
collection PubMed
description RATIONALE: Conjunctival papilloma is a benign neoplastic lesion of epithelial origin, with a minimal tendency toward malignancy and an exophytic growth type. Etiological factors that contribute to the appearance of papilloma are UV exposure, HPV infection, smoking, and immunodeficiency. A case report of limbal conjunctival papilloma treatment with topical interferon alpha-2b eye drops applied to the conjunctival sac. PATIENT CONCERNS: A 49-year-old female patient treated in the Clinical Department of Ophthalmology for conjunctival lesion located in the temporal quadrant near the limbus of the right eye. Ocular examination of the patient's eye did not show any abnormalities: visual acuity—20/20, intraocular pressure—16 mmHg. DIAGNOSES: During physical examination, a broad-based pink lesion of size 4 mm × 6 mm was found in interpalpebral bulbar conjunctiva with prominent feeder vessels and soft consistency. Lesion in the biomicroscopic examination did not show any sign of malignancy. In Swept Source Optical Coherence Tomography (SS-OCT) there was no sign of infiltration into sclera or cornea. In vivo confocal microscopy (IVCM) examination, revealed loss of the normal conjunctival epithelium - hyper-reflective cells, variation of cell size. A clinical diagnosis of limbal conjunctival papilloma was made. INTERVENTIONS: Interferon alpha-2b 1 million IU/ml eye drops were applied 4 times a day for 5 months. The treatment lasted 5 months without changing the dosing regimen. Three months after the start of the interferon treatment, a complete regression of the lesion was achieved. Treatment was continued for the following 2 months. Controlled IVCM after 6 months showed only few hyper-reflective cells and fibrotic tissue. OUTCOMES: Treatment of conjunctival papilloma with topical interferon alpha-2b led to the complete regression of the lesion. Although after the therapy the conjunctiva appears normal both in slit lamp and in the OCT examination, there is a noticeable fibrosis of the tissue in confocal microscopy. During the 14-month follow-up period, there were no recurrent lesions. LESSONS: In this study, topical interferon alpha-2b has been shown to be an effective and safe therapy for small-to-medium-size conjunctival papilloma without any sign of malignancy.
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spelling pubmed-70350652020-03-10 Treatment of conjunctival papilloma with topical interferon alpha-2b - case report Bolek, Bartłomiej Wylęgała, Adam Teper, Sławomir Kokot, Joanna Wylęgała, Edward Medicine (Baltimore) 5800 RATIONALE: Conjunctival papilloma is a benign neoplastic lesion of epithelial origin, with a minimal tendency toward malignancy and an exophytic growth type. Etiological factors that contribute to the appearance of papilloma are UV exposure, HPV infection, smoking, and immunodeficiency. A case report of limbal conjunctival papilloma treatment with topical interferon alpha-2b eye drops applied to the conjunctival sac. PATIENT CONCERNS: A 49-year-old female patient treated in the Clinical Department of Ophthalmology for conjunctival lesion located in the temporal quadrant near the limbus of the right eye. Ocular examination of the patient's eye did not show any abnormalities: visual acuity—20/20, intraocular pressure—16 mmHg. DIAGNOSES: During physical examination, a broad-based pink lesion of size 4 mm × 6 mm was found in interpalpebral bulbar conjunctiva with prominent feeder vessels and soft consistency. Lesion in the biomicroscopic examination did not show any sign of malignancy. In Swept Source Optical Coherence Tomography (SS-OCT) there was no sign of infiltration into sclera or cornea. In vivo confocal microscopy (IVCM) examination, revealed loss of the normal conjunctival epithelium - hyper-reflective cells, variation of cell size. A clinical diagnosis of limbal conjunctival papilloma was made. INTERVENTIONS: Interferon alpha-2b 1 million IU/ml eye drops were applied 4 times a day for 5 months. The treatment lasted 5 months without changing the dosing regimen. Three months after the start of the interferon treatment, a complete regression of the lesion was achieved. Treatment was continued for the following 2 months. Controlled IVCM after 6 months showed only few hyper-reflective cells and fibrotic tissue. OUTCOMES: Treatment of conjunctival papilloma with topical interferon alpha-2b led to the complete regression of the lesion. Although after the therapy the conjunctiva appears normal both in slit lamp and in the OCT examination, there is a noticeable fibrosis of the tissue in confocal microscopy. During the 14-month follow-up period, there were no recurrent lesions. LESSONS: In this study, topical interferon alpha-2b has been shown to be an effective and safe therapy for small-to-medium-size conjunctival papilloma without any sign of malignancy. Wolters Kluwer Health 2020-02-14 /pmc/articles/PMC7035065/ /pubmed/32049852 http://dx.doi.org/10.1097/MD.0000000000019181 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5800
Bolek, Bartłomiej
Wylęgała, Adam
Teper, Sławomir
Kokot, Joanna
Wylęgała, Edward
Treatment of conjunctival papilloma with topical interferon alpha-2b - case report
title Treatment of conjunctival papilloma with topical interferon alpha-2b - case report
title_full Treatment of conjunctival papilloma with topical interferon alpha-2b - case report
title_fullStr Treatment of conjunctival papilloma with topical interferon alpha-2b - case report
title_full_unstemmed Treatment of conjunctival papilloma with topical interferon alpha-2b - case report
title_short Treatment of conjunctival papilloma with topical interferon alpha-2b - case report
title_sort treatment of conjunctival papilloma with topical interferon alpha-2b - case report
topic 5800
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035065/
https://www.ncbi.nlm.nih.gov/pubmed/32049852
http://dx.doi.org/10.1097/MD.0000000000019181
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