Limbal Stem Cell Deficiency: A Rare Complication Associated with Atopic Dermatitis

Atopic dermatitis (AD) is commonly linked to the recurrent occurrence of bilateral allergic conjunctival inflammation, known as vernal keratoconjunctivitis (VKC). Very rarely VKC can lead to limbal stem cell deficiency which may cause permanent vision loss. This case report details a 9-year-old boy who, for the previous 6 years, had repeated episodes of multiple itchy, lesions over his upper and lower extremities, and trunk. In addition, the patient experienced bilateral itchy and red eyes, blurred vision, and recurrent conjunctivitis for 2 years. The diagnosis of AD was supported by a skin biopsy that produced histological findings compatible with the condition and a slit-lamp examination that revealed limbal stem cell deficiency in addition to cobblestone-like conjunctiva. The patient was treated effectively with topical midpotent steroids and tacrolimus for skin lesions and with amniotic membrane transplantation on bilateral eyes. This case report emphasizes the value of a comprehensive multispecialty approach for early diagnosis and treatment to prevent corneal ulcers and vision loss in AD patients, which can be permanently disabling.