Evidence map›Paper›PMID 41884461›Full record

ReviewWorld journal of virology2026

Phlyctenular keratoconjunctivitis with viral triggers.

Matteo Capobianco, Francesco Cappellani, Federico Visalli, Alessandro Avitabile, Giuseppe Gagliano, Simonetta Gaia Nicolosi, Marieme Khouyyi, Fabiana D'Esposito, Caterina Gagliano, Marco Zeppieri

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in World journal of virology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Matteo CapobiancoEye Clinic, Policlinico G. Rodolico, University of Catania, Catania 95121, Italy.
Francesco CappellaniDepartment of Medicine and Surgery, University of Enna "Kore", Enna 94100, Italy.
Federico VisalliDepartment of Ophthalmology, University of Catania, Catania 95123, Italy.
Alessandro AvitabileFaculty of Medicine, University of Catania, Catania 95123, Italy.
Giuseppe GaglianoEye Clinic, Policlinico G. Rodolico, University of Catania, Catania 95121, Italy.
Simonetta Gaia NicolosiFaculty of Medicine, University of Catania, Catania 95123, Italy.
Marieme KhouyyiDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina 98121, Italy.
Fabiana D'EspositoDepartment of Medicine and Surgery, University of Enna "Kore", Enna 94100, Italy.
Caterina GaglianoDepartment of Medicine and Surgery, University of Enna "Kore", Enna 94100, Italy.
Marco ZeppieriDepartment of Ophthalmology, University Hospital of Udine, Udine 33100, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Phlyctenular keratoconjunctivitis (PKC) goes beyond limbal nodules. This pediatric ocular surface condition caused by delayed-type hypersensitivity to microbial antigens. The trigger is context-dependent: Mycobacterial antigens in tuberculosis-endemic areas; staphylococcal eyelid disease and rosacea in high-income areas. Although classically bacterial-driven, virus-associated presentations like herpes simplex virus (HSV)-linked phlyctenular disease, pediatric PKC during acute coronavirus disease 2019 (COVID-19) infection, and molluscum contagiosum-driven keratoconjunctivitis suggest the same antigen-mediated pathway. Photophobia and discomfort are prevalent, and corneal involvement can cause neovascularization, scarring, amblyopia, and perforation. This minireview combines epidemiologic, clinical, and immunopathologic data to identify causes and update care. Practical takeaways: (1) Treat the antigen source (blepharitis/rosacea, chlamydia, parasites) and screen for tuberculosis when risk factors exist. Consider viral triggers when history or exam suggest HSV, recent COVID-19, or eyelid molluscum; (2) Suppress inflammation promptly with a short, carefully tapered course of topical corticosteroids; (3) Use topical cyclosporine as a steroid-sparing agent in recurrent or steroid-dependent disease; and (4) Reduce antigen load with lid hygiene and targeted antimicrobials. Start antitubercular treatment for tuberculosis. If a viral cause is anticipated, add antiviral medication or molluscum lesion eradication to the steroid-sparing regimen. Trigger-focused, steroid-sparing treatment reduces recurrences, vision-threatening consequences, and steroid exposure.

Indexed as

COVIDDelayed-type hypersensitivityHerpes simplex virusMolluscum contagiosumOcular rosaceaPediatric ophthalmologyPhlyctenular keratoconjunctivitisStaphylococcus aureusTuberculosisViral infection

Identifiers

PMID41884461
PMCPMC13010927

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.