Evaluation of cornea by confocal microscopy in patients with acne rozasea and pemfigus vulgaris

Aim and Object: To detect the changes that may occur at the cellular level in the cornea and to evaluate these changes with in vivo confocal microscopy in pemphigus vulgaris and acne rosacea patients which are dermatologic disorders known to affect the ocular surface. Material and Methods: A total of 17 pemphigus and 31 acne rosacea patients aged between 18 and 60 years followed up at the Dermatology Clinic of Van Yüzüncü Yıl University, Faculty of Medicine were included in the study and 30 healthy controls were included in the study. Shirmer I and tear break up time tests were performed. Corneal endothelial cell count was performed with specular microscopy. Corneal imaging was performed with optical coherence tomography and central corneal thickness was measured. Corneal layers were evaluated by confocal microscopy and cell counts were performed and one-way ANOVA test was performed to compare groups with descriptive statistics for data analysis. Results: In terms of endothelial number, the pemphigus group was significantly lower than the control group (p = 0,007), and there was no statistically significant difference between the rosacea group and the pemphigus group and the control group. No statistically significant difference was found between rosacea and pemphigus groups in terms of tear break-up time, and tear break-up time was significantly lower in these two groups compared to the control group (p = 0,001). In terms of basal cell number, the pemphigus group was significantly less than the other two groups, and the rosacea group was less than the control group (p = 0,001).Shirmer score, central corneal thickness, surface epithelial cell count, wing cell count, anterior keratocyte count, posterior keratocyte count, Langerhans cell count, main nerve count and total nerve branching were not statistically different among the groups. Conclusion: In our study, the findings we obtained from pemphigus vulgaris and rosacea patients were thought to be related to the dry eye caused by these diseases. Decrease in BUT, Schirmer I score and endothelial cell dencity in patients with pemphigus vulgaris and acne rosacea supports that.