Fungal involvement (Pityrosporum) in ocular allergy

• Published in: Acta ophthalmologica (Oxford, England) Vol. 97; no. S263
• Main Author: Chabane, Habib
• Format: Journal Article
• Language: English
• Published: Malden Wiley Subscription Services, Inc 01-12-2019
• Subjects: Allergens; Allergies; Atopic dermatitis; Blepharitis; Conjunctivitis; Dermatitis; Fungi; Hay fever; Head and neck; Immunoglobulin E; Keratoconjunctivitis; Microbiota; Seborrheic dermatitis; Skin diseases; Skin lesions
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2019.8180

Allergic conjunctivitis to atmospheric molds is well documented, Alternaria being by far the most common. However, the role of microbiota fungi in conjunctivitis is less documented. Several old reports until the seventies have underlined the implication of allergy to Candida albicans in some chronic conjunctivitis. Pityrosporum orbiculare allergy has been well documented in head and neck atopic dermatitis in adults, but there is no report showing the involvement of this fungi in chronic conjunctivitis, even if some authors suspected his involvement in blepharitis. Here we describe some case‐reports of atopic keratoconjunctivitis associated with IgE sensitization to Pityrosporum in adults with seborrheic dermatitis or head and neck dermatitis. Patients was initially treated by ciclosporin since no sensitization to aeroallergens have been highlighted. After local and systemic anti‐fungal treatment, ciclosporin was stopped and sustained improvement was observed under discontinuous treatment. When no sensitization to aeroallergens has been highlighted in atopic keratoconjunctivitis, we suggest to seek for sensitization to microbiota fungi particularly Pityrosporum spp. and Candida a. in patients with head skin lesions.