Vernal Keratoconjunctivitis and immune‐mediated diseases: One unique way to symptom control?

We report the case of a 15-year old boy affected by Vernal keratoconjunctivitis (VKC),\udasthma and atopic dermatitis (AD) treated with omalizumab with the control not only of\udrespiratory and cutaneous symptoms but also of ocular manifestation.\udA 15-year old adolescent suffering from persistent allergic asthma with a seven years history\udof severe ocular itching, discharge, irritation and mild photophobia increasing during the\udsummer, not responding to topical antihistamines, came to our attention at the Pediatric\udDepartment of the “Policlinico Umberto I” hospital in Rome. A severe atopic dermatitis\udsince the second month of age, firstly presenting as a diaper dermatitis, then involving the\udfolds of the limbs, and finally the face and the neck, especially the perioral and the periocular\udareas, was also referred. On ophtalmological\udevaluation he showed intense conjunctival hyperemia and the upper palpebral conjunctiva\udpresented giant palpillae in both eyes (Fig. 2a). A corneal center ulcer involving the left eye with intense pain, photophobia, and scarce visual acuity was found. In fact, best corrected visual acuity (BCVA) was 20/40 in left eye and 20/20 in right eye with Snellen chart.\udThe adolescent underwent a topic therapy with vancomycin, fusidic acid and atropine 1% for\ud2 months followed by the topical administration of artificial tears with 1% cyclosporine\udWe report the case of a young male affected by VKC associated with severe atopic dermatitis\udand uncontrolled asthma, two immunological diseases mediated by Immunoglobulin E. 1\udVKC is a rare and chronic relapsing condition involving conjunctiva and/or corneal tissue,\udoccurring mainly in children and adolescents, in dry and hot climates which can lead to visual\udloss