All of the following are included in the differential diagnosis of this condition shown in Figure
- herpes simplex virus (HSV)
- molluscum contagiosum
- allergic drug reaction
- Stevens–Johnson syndrome
This patient has a follicular conjunctivitis. Follicles are small avascular mounds of lymphocytes and plasma cells. Papillae are formed by edema and leakage of fluid from telangiectatic vessels. The differential diagnosis of a follicular conjunctivitis includes EKC, HSV, chlamydia, molluscum contagiosum, as well as topical drug reactions (type IV hypersensitivity to medications such as brimonidine or neomycin). Stevens–Johnson syndrome is a systemic autoimmune disease that causes sloughing of the mucous membranes (including the conjunctiva). This can be a reaction to medication from sulfonamides, Dilantin, and others. In milder cases, patients may present with a papillary conjunctivitis.