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blepharokeratoconjunctitis [2025/11/02 13:39] – [Treatment] Scott Larsonblepharokeratoconjunctitis [2026/09/16 08:34] (current) – [Treatment] Scott Larson
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 ====Risk Factors==== ====Risk Factors====
   * Poor hygiene   * Poor hygiene
-  * Seborrheic dermatitis +  * [[seborrheic_dermatitis|Seborrheic dermatitis]] 
-  * History of Atopy +  * History of [[atopy|Atopy]]- predisposition to produce IgE in response to common allergens 
   * Infestation with Demodex mites   * Infestation with Demodex mites
   * High levels of C.acnes bacteria in meibum cultures   * High levels of C.acnes bacteria in meibum cultures
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 ====Treatment==== ====Treatment====
 ===Bacteria=== ===Bacteria===
-  * [[azythromycin|Azithromycin]] 
-    * PO 250-500 mg thrice weekly for 4-8 weeks (5-10 mg/kg)   
-    * Topical: Azasite 1% ophthalmic solution most useful in maintenance of remission 
   * Erythromycin    * Erythromycin 
-    * PO 250-500 mg QD or BID x 4-8 weeks +    * Topical: 0.5% ointment, most helpful for maintaining remission  
-    * Topical: 0.5% ointment, most helpful for maintaining remission   +
-  * [[doxycycline|Doxycycline]] in children over 8 with their adult teeth.     +
-    * Low dose:  40 mg QD or 20 mg BID x 4-8 weeks  +
-    * Regular dose: 100 mg QD x 4-8 weeks+
 ===Demodex=== ===Demodex===
   * Tea Tree Oil 50% eyelid scrubs daily   * Tea Tree Oil 50% eyelid scrubs daily
     * [[https://www.amazon.com/s?k=tea+tree+oil+eyelid+wipes&crid=2S0A26H6IPQM4&sprefix=tea+tree+oild+%2Caps%2C251&ref=nb_sb_ss_p13n-expert-pd-ops-ranker_1_14 |Amazon search results]]     * [[https://www.amazon.com/s?k=tea+tree+oil+eyelid+wipes&crid=2S0A26H6IPQM4&sprefix=tea+tree+oild+%2Caps%2C251&ref=nb_sb_ss_p13n-expert-pd-ops-ranker_1_14 |Amazon search results]]
-  * Xdemvy drops +  * [[https://xdemvyhcp.com |Xdemvy drops (lotilaner ophthalmic solution 0.25%)]] BID x 6 weeks 
 +    * Send to BlinkRx  Phone: 1-833-919-4942 Fax: 1-866-585-4631 12639 W Explorer Dr, Suite 100 Boise, ID 83713  NPI #: 1891461885 
 +===Meibomian Gland Dysfunction=== 
 +  * Flaxseed oil- 1 Tsp/day = about 1800 ALA,  or 2 capsule about 720 ALA/capsule 
 +  * Azithromycin (preferred over erythromycin—better bioavailability, longer half-life, higher tissue concentration) 
 +    * 5 mg/kg daily for 2 months  
 +    * Pulsed/cyclic 5-7 day course,  one week on 3 week off 
 +    * Monitor for GI upset and QT prolongation. 
 +  * Topical: Azasite 1% ophthalmic solution most useful in maintenance of remission 
 +  * [[doxycycline|Doxycycline]] only in children over 8 with their adult teeth.     
 +    * Low dose:  40 mg QD or 20 mg BID x 4-8 weeks  
 +    * Regular dose: 100 mg QD x 4-8 weeks